18FDG-PET评价局部晚期和晚期非小细胞肺癌化疗的客观疗效

 目的 前瞻性地探索18-氟脱氧葡萄糖-正电子发射计算机断层扫描（18FDG-PET）的SUV值标准与实体瘤疗效评价标准（RECIST）标准评价非小细胞肺癌（NSCLC）化疗的客观疗效是否具有一致性。方法 初治不可切除的局部晚期和晚期NSCLC患者前瞻性入组，行两周期含铂双药方案全身化疗。按RECIST标准和SUV值标准（2个周期化疗后SUV值下降大于30 %）互为盲法分别评价肿瘤客观疗效。用配对计数资料的χ2检验和κ系数检验比较18FDG-PET代谢缓解与RECIST标准的客观疗效是否具有一致性（SPSS13.0）。结果 不可切除的局部晚期8例，晚期35例。18FDG-PET代谢缓解与按RECIST标准评价的疗效具有明显的一致性（P＜0.001）。18FDG-PET评价NSCLC化疗客观疗效的敏感性、特异性、准确性、阳性预测值和阴性预测值分别是94 %、70 %、80 %、67 %和95 %。结论 18FDG-PET可以评价局部晚期和晚期NSCLC化疗的客观疗效。

Assessment of objective response to chemotherapy in non-small cell lung cancer by 18FDG-PET

Objective To prospectively evaluate the use of positron emission tomography(PET) with the glucose analog 18-fluorodeoxyglucose(18FDG) to assess objective response after chemotherapy in patients with unresectable locally advanced non-small cell lung cancer(NSCLC) or advanced NSCLC. Methods Pa－tients with unresectable locally advanced NSCLC or advanced NSCLC were prospectively enrolled into this study to undergo platinum-based doublet chemotherapy. Patients were studied by 18FDG-PET before and after the first two cycles of chemotherapy. A reduction of tumor 18FDG uptake by more than 30% as assessed by standardized uptake value(SUV) was used as a criterion for a metabolic response.Compare RECIST response with 18FDG-PET metabolic response by the way of χ 2 test and κ test (SPSS13.0). Results 43 patients(8 cas－es with locally advanced NSCLC and 35 cases with advanced NSCLC) were included in the study. There was a close correlation between metabolic response and objective response to chemotherapy according to RECIST (P ＜ 0.001); Sensitivity, specificity, accuracy, prediction of positive value and prediction of negative value were 94 %, 70 %, 80 %, 67 % and 95 % respectively. Conclusion Reduction of SUV in 18FDG-PET after two-cycle chemotherapy for NSCLC is closely correlated with objective response.