摘要
目的探讨基线氟-18-氟代脱氧葡萄糖(^(18)F-FDG)正电子发射计算机断层扫描(PET/CT)代谢参数与晚期非小细胞肺癌(NSCLC)一线免疫检查点抑制剂(ICI)联合化疗预后的关系。方法回顾性分析2019至2021年于郑州大学附属肿瘤医院接受基线PET/CT检查且行一线ICI联合化疗的晚期NSCLC患者。采用受试者工作特征曲线(ROC)获得总肿瘤代谢体积(TMTV)、糖酵解总量(TLG)和最大标准摄取值(SUVmax)与一线ICI联合化疗预后的最佳临界值,并收集患者外周血指标,采用Kaplan-Meier法、Log-rank法及Cox回归计算总生存(OS)及无进展生存(PFS)。结果共入组44例患者。单因素分析显示,TMTV>119.5 cm3及转移灶数量>3个与较差的PFS有关(χ^(2)=4.19、11.28,P<0.05);TMTV>119.5 cm3及TLG>424.3与较差的OS有关(χ^(2)=14.96、6.05,P<0.05)。多因素分析显示,转移灶数量是PFS的独立预后因素(P=0.011),TMTV是OS的独立预后因素(P=0.038)。结论在接受一线ICI治疗联合化疗的晚期NSCLC患者中,TMTV是OS的独立预后指标,转移灶数量是PFS的独立预后指标,可在临床工作中应用,但仍需前瞻性研究进一步证实。
Objective To investigate the prognostic value of metabolic parameters of ^(18)F-fluorodeoxyglucose(^(18)F-FDG)positron emission computed tomography/computed tomography(PET/CT)in advanced non-small cell lung cancer(NSCLC)treated with first-line immune checkpoint inhibitor(ICI)combined with chemotherapy.Methods A retrospective study was conducted to evaluate patients with advanced NSCLC who underwent baseline PET/CT before treatment at the Affiliated Cancer Hospital of Zhengzhou University from 2019 to 2021.Receiver operating characteristic(ROC)curve analysis was used to determine the cut-offs for metabolic parameters of PET/CT,including total metabolic tumor volume(TMTV),total lesion glycolysis(TLG),and maximum standard uptake value(SUVmax).Kaplan-Meier method,Log-rank test,and Cox regression model were used to calculate the overall survival(OS)and the progression-free survival(PFS).Results A total of 44 patients were enrolled.Univariate analysis showed that the factors influencing PFS were TMTV and the number of metastatic sites(χ^(2)=4.19,11.28,P<0.05)and the factors influencing OS were TMTV and TLG(χ^(2)=14.96,6.05,P<0.05).Multivariate analysis suggested that number of metastatic sites was an independent prognostic marker for PFS(P=0.011)and TMTV was an independent prognostic marker for OS(P=0.038).Conclusions TMTV is a prognostic indicator of OS while the number of metastatic sites is a prognostic indicator of PFS in advanced NSCLC patients who received first-line ICI combined with chemotherapy,but further prospective studies are needed.
作者
王韵涵
孙亚楠
李鹏
杨建伟
王晓辉
张朕钦
郑晓丽
罗辉
叶柯
葛红
Wang Yunhan;Sun Yanan;Li Peng;Yang Jianwei;Wang Xiaohui;Zhang Zhenqin;Zheng Xiaoli;Luo Hui;Ye Ke;Ge Hong(Department of Radiation Oncology,Affiliated Cancer Hospital of Zhengzhou University,Henan Cancer Hospital,Zhengzhou 450008,China;PET/CT Center of Henan Province,Affiliated Cancer Hospital of Zhengzhou University,Henan Cancer Hospital,Zhengzhou 450008,China)
出处
《中华放射医学与防护杂志》
CAS
CSCD
北大核心
2023年第2期87-93,共7页
Chinese Journal of Radiological Medicine and Protection
基金
河南省科技攻关项目(222102310015)
河南省医学科技攻关项目(SBGJ202102056)。
