Prognostic value of baseline 18F-FDG PET/CT metabolic parameters in locally advanced cervical cancer after concurrent chemoradiotherapy
10.3760/cma.j.cn321828-20230419-00107
- VernacularTitle:基线 18F-FDG PET/CT代谢参数在局部晚期宫颈癌同步放化疗中的预后预测价值
- Author:
Huiling LIU
1
;
Mi LAO
;
Cheng CHANG
;
Yongbin CUI
;
Yalin ZHANG
;
Yong YIN
;
Ruozheng WANG
Author Information
1. 新疆肿瘤学重点实验室，新疆医科大学附属肿瘤医院放疗中心，乌鲁木齐 830011
- Keywords:
Uterine cervical neoplasms;
Chemoradiotherapy;
Positron-emission tomography;
Tomography, X-ray computed;
Fluorodeoxyglucose F18;
Prognosis
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2024;44(3):153-158
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the prognostic value of baseline 18F-FDG PET/CT metabolic parameters in locally advanced cervical cancer (LACC) after concurrent chemoradiotherapy (CCRT). Methods:From September 2015 to October 2021, the clinical data of 180 LACC patients (age: 22-76 years) who underwent 18F-FDG PET/CT before CCRT at Affiliated Cancer Hospital of Shandong First Medical University were analyzed retrospectively. The metabolic tumor volume (MTV), total lesion glycolysis (TLG), SUV max, and SUV mean were computed by using the margin threshold of 42%SUV max. The optimal threshold for predicting progression-free survival (PFS) was obtained by ROC curve analysis. The Kaplan-Meier method was applied for survival analysis, and the log-rank test was applied to compare the survival rate between groups. Multivariate Cox proportional hazard regression was used to analyze progression for PFS. Results:The median follow-up was 19.1 months, and 54 patients (30.0%, 54/180) suffered from disease progression. ROC curve analysis showed that the optimal cut-off value of MTV was 31.145 ml, with the AUC of 0.641. Para-aortic lymph node (PALN) metastasis had the highest AUC value (0.589) among the clinical factors, followed by International Federation of Gynecology and Obstetrics (FIGO) stage (0.581). The 1-year PFS rates of patients with MTV<31.145 ml ( n=88) and MTV≥31.145 ml ( n=92) were 80.68% and 59.78%, respectively ( χ2=13.72, P<0.001). Multivariate Cox analysis demonstrated that pathological type (hazard ratio ( HR)=3.075, 95% CI: 1.370-6.901, P=0.006), FIGO stage ( HR=1.955, 95% CI: 1.031-3.707, P=0.040), PALN metastasis ( HR=2.136, 95% CI: 1.202-3.796, P=0.010) and MTV ( HR=2.449, 95% CI: 1.341-4.471, P=0.004) were the significant predictors for PFS. Conclusions:Pathological type, FIGO stage, PALN metastasis and MTV are independent prognostic risk factors for PFS. MTV as the baseline 18F-FDG PET/CT metabolic parameter, can realize prognostic stratification analysis.
