Abstract：
OBJECTIVE: The aim of our prospective study was to assess the prognostic value of 18F-FDG PET/CT performed two months post treatment for anal canal neoplasm.
METHODS: Consecutive patients with histologically proved anal cancer, with 18F-FDG PET/CT pre and two months post treatment were included. Patients were not previously treated for this neoplasm and then received radiotherapy ± chemotherapy. Clinical and pathologic data were collected and for 18F-FDG PET/CT visual and quantitative analysis (standardized uptake value, metabolic volume) were performed; response was classified according to EORTC and PERCIST criteria. The results were assessed for disease free survival and local recurrence free survival using the log-Rank test RESULTS: From December 2014 to September 2019, 94 consecutive patients were screened and 78 were included in this study. Median follow-up was 51 months. Two months post treatment, 37 patients (47.4%) had a complete radiological response according to both EORTC and PERCIST criteria, 66 patients (84.6%) had a clinical complete response. For disease free survival, the prognostic value of complete response was statistically significant (p=0.02) with 18F-FDG PET/CT and with clinical examination (p<0.001). For local recurrence free survival, the prognostic value with 18F-FDG PET/CT was lower (p=0.04) than clinical examination (p < 0.007).
CONCLUSIONS: While clinical examination remains the gold standard for post treatment evaluation in anal cancer, 18F-FDG PET/CT has a statistically significant prognostic value. These two assessments could be combined to improve early evaluation.
METHODS: Consecutive patients with histologically proved anal cancer, with 18F-FDG PET/CT pre and two months post treatment were included. Patients were not previously treated for this neoplasm and then received radiotherapy ± chemotherapy. Clinical and pathologic data were collected and for 18F-FDG PET/CT visual and quantitative analysis (standardized uptake value, metabolic volume) were performed; response was classified according to EORTC and PERCIST criteria. The results were assessed for disease free survival and local recurrence free survival using the log-Rank test RESULTS: From December 2014 to September 2019, 94 consecutive patients were screened and 78 were included in this study. Median follow-up was 51 months. Two months post treatment, 37 patients (47.4%) had a complete radiological response according to both EORTC and PERCIST criteria, 66 patients (84.6%) had a clinical complete response. For disease free survival, the prognostic value of complete response was statistically significant (p=0.02) with 18F-FDG PET/CT and with clinical examination (p<0.001). For local recurrence free survival, the prognostic value with 18F-FDG PET/CT was lower (p=0.04) than clinical examination (p < 0.007).
CONCLUSIONS: While clinical examination remains the gold standard for post treatment evaluation in anal cancer, 18F-FDG PET/CT has a statistically significant prognostic value. These two assessments could be combined to improve early evaluation.
摘要：
目的：我们的前瞻性研究的目的是评估18F-FDGPET/CT治疗肛管肿瘤2个月后的预后价值。
方法：连续的经组织学证实的肛门癌患者，包括治疗前和治疗后两个月的18F-FDGPET/CT。患者以前没有接受过这种肿瘤的治疗，然后接受了放疗±化疗。收集临床和病理数据，并进行18F-FDGPET/CT视觉和定量分析（标准化摄取值，代谢体积）；根据EORTC和PERCIST标准对反应进行分类。使用log-Rank检验结果评估无病生存率和无局部复发生存率：2014年12月至2019年9月，筛选了94例连续患者，其中78例纳入本研究。中位随访时间为51个月。治疗后两个月,根据EORTC和PERCIST标准，37例患者（47.4%）有完全的放射学反应，66例（84.6%）患者临床完全缓解。为了无疾病生存，在18F-FDGPET/CT和临床检查中,完全缓解的预后价值具有统计学意义(p=0.02)(p<0.001).对于局部无复发生存，18F-FDGPET/CT的预后价值(p=0.04)低于临床检查(p<0.007).
结论：虽然临床检查仍然是肛门癌治疗后评估的金标准，18F-FDGPET/CT具有统计学意义的预后价值。这两项评估可以结合起来，以改善早期评估。
方法：连续的经组织学证实的肛门癌患者，包括治疗前和治疗后两个月的18F-FDGPET/CT。患者以前没有接受过这种肿瘤的治疗，然后接受了放疗±化疗。收集临床和病理数据，并进行18F-FDGPET/CT视觉和定量分析（标准化摄取值，代谢体积）；根据EORTC和PERCIST标准对反应进行分类。使用log-Rank检验结果评估无病生存率和无局部复发生存率：2014年12月至2019年9月，筛选了94例连续患者，其中78例纳入本研究。中位随访时间为51个月。治疗后两个月,根据EORTC和PERCIST标准，37例患者（47.4%）有完全的放射学反应，66例（84.6%）患者临床完全缓解。为了无疾病生存，在18F-FDGPET/CT和临床检查中,完全缓解的预后价值具有统计学意义(p=0.02)(p<0.001).对于局部无复发生存，18F-FDGPET/CT的预后价值(p=0.04)低于临床检查(p<0.007).
结论：虽然临床检查仍然是肛门癌治疗后评估的金标准，18F-FDGPET/CT具有统计学意义的预后价值。这两项评估可以结合起来，以改善早期评估。
