PDF(Pubmed)
Abstract：
UNASSIGNED: Induction therapy followed by surgery is recommended as an alternative treatment strategy for locally advanced non-small cell lung cancer (NSCLC). Patients who achieve pathologic response after induction therapy have better outcomes than non-responders; therefore, therapeutic response must be evaluated. Recently, new approaches for monitoring therapeutic responses, which are based on 18F-Fluorodeoxyglucose positron emission tomography (FDG-PET), have been developed. In this study, we evaluated the predictive value of Positron Emission Tomography Response Criteria in Solid Tumors (PERCIST), which uses standardized uptake values corrected for lean body mass (SUL) and total lesion glycolysis (TLG).
UNASSIGNED: A total of 130 patients in the Setouchi Lung Cancer Group who underwent FDG-PET imaging before and after induction therapy prior to a planned surgical resection for NSCLC between 2007 and 2016 were studied retrospectively. The pathologic responses of the primary lung tumors and metastatic lymph nodes were compared with their responses based on evaluation using PERCIST.
UNASSIGNED: Postoperative pathologic studies revealed pathologic complete response (pCR) in 42 (32.3%) patients. PERCIST was significantly correlated with pathologic response (p < 0.001). The sensitivity, specificity, and accuracy of PERCIST for predicting pCR were 16.7% (7/42), 88.6% (78/88), and 65.4% (85/130), respectively. Patients with pCR had significantly higher reduction rates in SULpeak for both primary lung tumors and metastatic lymph nodes and TLG for primary tumors than non-responders. In a multivariate Cox regression analysis, tumor site in upper lobes, reduction rate of TLG in primary tumor, and pathologic N0 were independent predictors of favorable recurrence-free survival (RFS).
UNASSIGNED: Our study suggested that PERCIST, especially the rate of TLG reduction rate, are useful to predict the pathological response and prognosis after induction therapy. Although improvement is necessary, PERCIST can be a promising method of the post-induction status in lung cancer. Further research is needed to confirm our findings.
UNASSIGNED: A total of 130 patients in the Setouchi Lung Cancer Group who underwent FDG-PET imaging before and after induction therapy prior to a planned surgical resection for NSCLC between 2007 and 2016 were studied retrospectively. The pathologic responses of the primary lung tumors and metastatic lymph nodes were compared with their responses based on evaluation using PERCIST.
UNASSIGNED: Postoperative pathologic studies revealed pathologic complete response (pCR) in 42 (32.3%) patients. PERCIST was significantly correlated with pathologic response (p < 0.001). The sensitivity, specificity, and accuracy of PERCIST for predicting pCR were 16.7% (7/42), 88.6% (78/88), and 65.4% (85/130), respectively. Patients with pCR had significantly higher reduction rates in SULpeak for both primary lung tumors and metastatic lymph nodes and TLG for primary tumors than non-responders. In a multivariate Cox regression analysis, tumor site in upper lobes, reduction rate of TLG in primary tumor, and pathologic N0 were independent predictors of favorable recurrence-free survival (RFS).
UNASSIGNED: Our study suggested that PERCIST, especially the rate of TLG reduction rate, are useful to predict the pathological response and prognosis after induction therapy. Although improvement is necessary, PERCIST can be a promising method of the post-induction status in lung cancer. Further research is needed to confirm our findings.
摘要：
■推荐诱导治疗后手术作为局部晚期非小细胞肺癌（NSCLC）的替代治疗策略。诱导治疗后达到病理反应的患者比无反应者有更好的结果；因此，必须评估治疗反应。最近,监测治疗反应的新方法，基于18F-氟脱氧葡萄糖正电子发射断层扫描（FDG-PET），已经开发了。在这项研究中,我们评估了正电子发射断层扫描反应标准在实体肿瘤中的预测价值（PERCIST），使用针对瘦体重（SUL）和总病变糖酵解（TLG）校正的标准化摄取值。
■在2007年至2016年期间，Setouchi肺癌组共130例患者在计划的NSCLC手术切除前的诱导治疗前后接受了FDG-PET成像。根据使用PERCIST的评估，将原发性肺肿瘤和转移性淋巴结的病理反应与其反应进行比较。
■术后病理研究显示42例（32.3%）患者出现病理完全缓解（pCR）。PERCIST与病理反应显著相关(p<0.001)。敏感性,特异性，PERCIST预测pCR的准确率为16.7%(7/42)，88.6%（78/88），和65.4%(85/130)，分别。对于原发性肺肿瘤和转移性淋巴结，pCR患者的SULpeak降低率明显高于无反应者。在多元Cox回归分析中，上叶肿瘤部位，TLG在原发性肿瘤中的降低率，和病理N0是有利的无复发生存率（RFS）的独立预测因子。
■我们的研究表明，特别是TLG减少率，有助于预测诱导治疗后的病理反应和预后。虽然改进是必要的，PERCIST可能是肺癌诱导后状态的一种有希望的方法。需要进一步的研究来证实我们的发现。
■在2007年至2016年期间，Setouchi肺癌组共130例患者在计划的NSCLC手术切除前的诱导治疗前后接受了FDG-PET成像。根据使用PERCIST的评估，将原发性肺肿瘤和转移性淋巴结的病理反应与其反应进行比较。
■术后病理研究显示42例（32.3%）患者出现病理完全缓解（pCR）。PERCIST与病理反应显著相关(p<0.001)。敏感性,特异性，PERCIST预测pCR的准确率为16.7%(7/42)，88.6%（78/88），和65.4%(85/130)，分别。对于原发性肺肿瘤和转移性淋巴结，pCR患者的SULpeak降低率明显高于无反应者。在多元Cox回归分析中，上叶肿瘤部位，TLG在原发性肿瘤中的降低率，和病理N0是有利的无复发生存率（RFS）的独立预测因子。
■我们的研究表明，特别是TLG减少率，有助于预测诱导治疗后的病理反应和预后。虽然改进是必要的，PERCIST可能是肺癌诱导后状态的一种有希望的方法。需要进一步的研究来证实我们的发现。
