FDG PET标准摄取值与非小细胞肺癌三维适形放疗预后的相关性

摘要

目的 探讨非小细胞肺癌患者在三维适形放疗前接受氟脱氧葡萄糖正电子发射断层扫描(FBG PET)的标准摄取值(SUV)与放疗预后的相关性.方法 73例Ⅲ期非小细胞肺癌(NSCLC)患者放疗前2周内行FDG PET扫描并计算最大SUV值.60～66 Gy放疗后将SUV作为考察因素之一进行Logrank法单因素分析,对有统计学意义的因素进一步用Cox模型行多因素预后分析.结果 不同病理类型的SUV平均值鳞癌为16.94,腺癌为14.40,其他为6.33(F=0.51,P=0.604).肿瘤不同体积的SUV平均值<50 cm~3为13.81,≥50 cm~3为20.18(F=7.54,P=0.008).不同SUV值判断预后的价值比较结果 显示SUV临界值以17为最佳.单因素预后分析显示SUV<17或≥17、是否化疗与预后相关.多因素预后分析显示SUV值是独立的生存预后因素,其中SUV≥17的相对危险度为2.61.结论 SUV值与NSCLC三维适形放疗预后有一定相关性,值得进一步临床大样本研究.%Objective To evaluate the prognostic value of fluorodeoxyglucose (FDG) standardized uptake value (SUV) of positron emission tomography (PET) before radiotherapy in non-small cell lung cancer (NSCLC) treated with three-dimensional conformal radiation therapy (3DCRT). Methods Seventy-three patients with stage Ⅲ NSCLC underwent PET to calculate SUV within 2 weeks before 3DCRT. The a-nalysis was carried out after the irradiation of 60 -66 Gy. The possible prognostic factors were assessed by Cox proportional hazards model. Results The mean SUV for squamous cell carcinoma, adenocarcinoma and others were 16.94, 14.40 and 6.33, respectively (F = 0. 51, P = 0. 604). The mean SUV for tumor volume less than and more than 50 cm~3 was 13.81 and 20.18 (F = 7.54, P = 0. 008). In the univariate analysis, a cutoff SUV of 17 and chemotherapy were correlated with the prognosis. In the multivariate analysis, SUV was the only independent prognostic factor (relative risk = 2.61). Conclusions SUV is a prognostic factor in patients with NSCLC treated by 3DCRT, which deserves further studies.