Objective To discuss the clinical feasibility of using 18F - FDG PET/CT imaging to evaluate the prognosis of hepatocellular carcinoma (HCC) that is treated with sorafenib. Methods A total of 40 patients with advanced HCC, who were admitted to authors' hospital during the period from June 2005 to July 2011, were enrolled in this study. All the patients received orally administered sorafenib therapy. Before and after the treatment 18F - FDG PET/CT imaging was performed, the maximum standardized uptake value (SUVmax) of the hepatic lesion was determined, and the therapeutic efficacy was evaluated. The factors affecting the overall survival (OS) time and progress - free survival (PFS) time were analyzed by using multivariable analysis method. Results All the patients were followed up for 2 - 18 months with a median of 9 months. Of the 40 patients, partial response was obtained in 3 and stable disease was seen in 22, and the overall effective rate was 62.5%. The median OS and PFS were 6.1 months (95% CI: 0.0 - 12.0) and 4.8 months (95% CI: 1.4 — 7.2) respectively. The multivariate analysis of OS showed that the following four indices were the independent factors that affected the prognosis: eastern cooperative oncology group (ECOG) performance status, α-fetoprotein concentration, portal vein thrombosis and SUVmax. AFP level and SUVmax were the independent prognostic factors affecting PFS. Based on the optimal critical value of SUVmax (= 5.5), the patients were divided into low SUVmax group (n = 14) and high SUVmax group (n = 26). Thernvalues of OS and PFS of the low SUVmax group were significantly higher than those of the high SUVmax group (P = 0.009 and P = 0.003). Conclusion SUVmax determined by 18F-FDG PET/CT imaging is an useful independentrnprognostic factor for the evaluation of advanced HCC that is treated with orally administered sorafenib therapy.%目的 探讨18F-FDG PET/CT显像评价索拉非尼治疗肝细胞癌预后的可行性.方法 分析2005年6月至2011年7月40例口服索拉非尼的中晚期HCC患者的临床资料,治疗前后行18F-FDGPET/CT检查,并记录每例患者肝内病灶区最大标准化摄取值(SUVmax),评价其疗效,Cox模型分析影响总生存期(OS)和无肿瘤进展生存期(PFS)的因素.结果 40例患者随访中位时间9(2～18)个月,3例患者达到部分缓解,22例患者疾病稳定,总有效率为62.5％.中位生存期和PFS分别为6.1个月(95％CI:0～12)和4.8个月(95％CI:1,4～ 7.2).多因素分析显示,ECOG评分,甲胎蛋白(AFP)水平,门静脉主干癌栓和SUVmax是影响OS独立预后因素.AFP水平和SUVmax是影响PFS独立预后因素.根据SUVmax最佳临界值将患者分为低SUVmax值和高SUVmax值两组:低SUV组的OS和PFS明显大于高SUV组(P分别为0.009和0.003).结论 索拉非尼治疗进展期HCC,18F-FDG PET/CT显像的SUVmax有价值的预后因素之一.
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