Prognostic value of volumetric metabolic parameters measured by18F-FDG PET/CT in patients with small cell lung cancer = 소세포폐암에서 18F-FDG PET/CT를 이용한 종량적 대사지표의 예후 예측 인자로서의 역할

다국어 초록 (Multilingual Abstract)

Purpose We evaluated the prognostic value of volume-based metabolic positron emission tomography (PET) parameters in patients with small cell lung cancer (SCLC) compared with other factors.
Materials and Methods The subjects were 202 patients with pathologically proven SCLC who underwent pretreatment 18F-Fluorodeoxyglucose PET/computed tomography (CT). Volumetric metabolic parameters of intrathoracic malignant hypermetabolic lesions, including maximum and average standardized uptake value, sum of metabolic tumor volume (MTV), and sum of total lesion glycolysis (TLG) were measured.
Results One hundred sixty eight patients had died during follow-up (median 17.4 months) and median progression free survival was 7 months and median overall survival was 13 months. On univariate survival analysis, age, stage, treatment modality, sum of MTV (cutoff = 100 cm3), and sum of TLG (cutoff = 555 g) were significant predictors of progression free survival and overall survival. There was a very high correlation between the sum of MTV and the sum of TLG (r = 0.963, P < 0.001). On multivariate survival analysis, age, stage, and sum of MTV were independent prognostic factors of progression free survival and overall survival. On subgroup analysis based on limited disease (LD) and extensive disease (ED), sum of MTV and sum of TLG were significant prognostic factors of overall survival only in LD. On the contrary, those were significant prognostic factors of progression free survival only in ED.
Conclusion Both sum of MTV and sum of TLG of intrathoracic malignant hypermetabolic lesions are important independent prognostic factors for survival in patients with SCLC, in addition to age and clinical stage. Volumetric metabolic parameters may be more useful as prognostic factors of overall survival in patients with SCLC of LD rather than of ED. On the contrary, those may be more useful to predict progression free survival in patients with ED rather than LD.

목차 (Table of Contents)

• ABSTRACT 1
• 1. Introduction 3
• 2. Methods 5
• 2.1 Patients 5
• 2.2 18F-FDG PET/CT 5
• 2.3 Measurement of PET/CT parameters 6
• 2.4 Treatment and clinical follow-up 7
• 2.5 Statistical analysis 7
• 3. Results 9
• 3.1 Patients’ characteristics 9
• 3.2 Variables for survival analysis 9
• 3.3 Univariate survival analysis 10
• 3.4 Multivariate survival analysis 10
• 3.5 Subgroup analysis according to the stage (LD or ED) 10
• 3.6 Comparisons in patients’ characteristics, PET parameters and survival analysis according to the model of PET/CT scanner 11
• 4. Discussion 12
• 5. References 16
• 6. Abstract (in Korean) 36