摘要
目的研究化疗中期及化疗后18F－脱氧葡萄糖（FDG）PET/CT对弥漫性大B细胞淋巴瘤（DLBCL）患者预后判断的价值。方法2008至2016年初始化疗方案为利妥昔单克隆抗体＋环磷酰胺＋阿霉素＋长春新碱＋泼尼松（R－CHOP）的DLBCL患者116例[男∶女＝1∶1.32，平均年龄（57.87±15.89）岁]，分别在化疗前、化疗中期及化疗后行18F－FDG PET/CT检查。研究终点为无进展生存（PFS）期和总体生存（OS）期。对化疗中期及化疗后代谢参数[最大标准摄取值（SUVmax）、肿瘤代谢体积（MTV）、病灶糖酵解总量（TLG）、Deauville评分（DS）]及化疗前后参数变化值ΔSUVmax、ΔMTV、ΔTLG行Pearson相关分析。以受试者工作特征（ROC）曲线判断各参数预后预测能力。采用Kaplan－Meier法行生存分析，通过Cox回归模型计算风险比（HR）。结果化疗中期与化疗后ΔSUVmax、ΔMTV、ΔTLG间的r值分别为0.630（P〈0.01）、0.912（P〈0.01）和0.955（P〈0.01）；2次检查DS一致率为89.7%（104/116），r值为0.733（P〈0.01）。化疗中期各指标判断疾病进展的能力均高于治疗结束后。化疗中期DS 1～3分组患者5年PFS率（83.1%与35.9%，P〈0.01；HR＝5.969，P〈0.01）和OS率（95.7%与75.5%，P〈0.01；HR＝8.161，P〈0.05）高于4～5分组。结论对于初始化疗方案为R－CHOP的DLBCL患者，化疗中期PET/CT能有效预测预后，化疗中期完全缓解的患者可省略化疗后PET/CT检查。
ObjectiveTo compare the value of interim and end-of-treatment 18F-fluorodeoxyglucose （FDG） PET/CT for the prognosis of patients with diffuse large B-cell lymphoma （DLBCL）.MethodsA total of 116 DLBCL patients （male∶female=1∶1.32, average age： （57.87±15.89） years） whose initial treatment was rituximab＋ cyclophosphamide＋ doxorubicin＋ vincristine＋ prednisone（R-CHOP）, were enrolled from 2008 to 2016. All patients underwent pre-treatment, interim and end-of-treatment 18F-FDG PET/CT. End points were progression-free survival （PFS） and overall survival （OS）. Correlation between metabolic parameters including maximum standardized uptake value （SUVmax）, metabolic tumor volume （MTV）, total lesion glycolysis （TLG）, Deauville score （DS）, ΔSUVmax, ΔMTV, ΔTLG in the interim PET/CT and those in the end-of-treatment PET/CT was analyzed with Pearson correlation analysis. The ability of metabolic parameters to assess the prognosis was evaluated by receiver operating characteristic（ROC） curve analysis. The survival was analyzed by Kaplan-Meier method and hazard ratio （HR） was calculated by Cox regression model.ResultsThe r values for ΔSUVmax, ΔMTV, ΔTLG of interim and end-of-treatment PET/CT were 0.630, 0.912, 0.955, respectively （all P〈0.01）. One hundred and four cases （89.7%, 104/116）had the same DS in the interim and end-of-treatment PET/CT, and the r value for DS between two PET/CT scans was 0.733 （P〈0.01）. The interim metabolic parameters were superior to that at the end of treatment in evaluating the progression. The 5-year PFS（83.1% vs 35.9%, P〈0.01; HR=5.969, P〈0.01） and OS （95.7% vs 75.5%, P〈0.01; HR=8.161, P〈0.05） rates were significantly higher in DS 1-3 group than those in DS 4-5 group.ConclusionsInterim PET/CT is effective for the prediction of prognosis in DLBCL patients with R-CHOP treatment. Patients with complete remission in the interim can omit the end-of-treatment PET/CT.
作者
陈虞梅
周明舸
刘建军
黄钢
Chen Yumei;Zhou Mingge;Liu Jianjun;Huang Gang(Department of Nuclear Medicine,Renji Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200127,China)
出处
《中华核医学与分子影像杂志》
CAS
北大核心
2018年第9期598-601,共4页
Chinese Journal of Nuclear Medicine and Molecular Imaging
基金
国家自然科学基金（81530053）
2017年上海教委高校教师产学研践习计划
上海市科学技术委员会科研计划（17411953200）
