https://scholars.lib.ntu.edu.tw/handle/123456789/429964
標題: | TLG-S criteria are superior to both EORTC and PERCIST for predicting outcomes in patients with metastatic lung adenocarcinoma treated with erlotinib | 作者: | Ho KC Fang YD Chung HW Liu YC Chang JW Hou MM Yang CT Cheng NM Su TP Yen TC HSIAO-WEN CHUNG |
關鍵字: | Erlotinib; FDG-PET; Lung cancer; Outcomes; Survival; Tumor response | 公開日期: | 2016 | 卷: | 43 | 來源出版物: | European Journal of Nuclear Medicine and Molecular Imaging | 摘要: | Purpose: In this retrospective review of prospectively collected data, we sought to investigate whether early FDG-PET assessment of treatment response based on total lesion glycolysis measured using a systemic approach (TLG-S) would be superior to either local assessment with EORTC (European Organization for Research and Treatment of Cancer) criteria or single-lesion assessment with PERCIST (PET Response Criteria in Solid Tumors) for predicting clinical outcomes in patients with metastatic lung adenocarcinoma treated with erlotinib. We also examined the effect of bone flares on tumor response evaluation by single-lesion assessment with PERCIST in patients with metastatic bone lesions. Methods: We performed a retrospective review of prospectively collected data from 23 patients with metastatic lung adenocarcinoma treated with erlotinib. All participants underwent FDG-PET imaging at baseline and on days 14 and 56 after completion of erlotinib treatment. In addition, diagnostic CT scans were performed at baseline and on day 56. FDG-PET response was assessed with TLG-S, EORTC, and PERCIST criteria. Response assessment based on RECIST 1.1 (Response Evaluation Criteria in Solid Tumors) from diagnostic CT imaging was used as the reference standard. Two-year progression-free survival (PFS) and overall survival (OS) served as the main outcome measures. Results: We identified 13 patients with bone metastases. Of these, four (31?%) with persistent bone uptake due to bone flares on day 14 were erroneously classified as non-responders according to the PERCIST criteria, but they were correctly classified as responders according to both the EORTC and TLG-S criteria. Patients who were classified as responders on day 14 based on TLG-S criteria had higher rates of 2-year PFS (26.7?% vs. 0?%, P = 0.007) and OS (40.0?% vs. 7.7?%, P = 0.018). Similar rates were observed in patients who showed a response on day 56 based on CT imaging according to the RECIST criteria. Patients classified as responders on day 14 according to the EORTC criteria on FDG-PET imaging had better rates of 2-year OS than did non-responders (36.4?% vs. 8.3?%, P = 0.015). Conclusions: TLG-S criteria may be of greater help in predicting survival outcomes than other forms of assessment. Bone flares, which can interfere with the interpretation of treatment response based on PERCIST criteria, are not uncommon in patients with metastatic lung adenocarcinoma treated with erlotinib. ? 2016, Springer-Verlag Berlin Heidelberg. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/429964 | ISSN: | 16197070 | DOI: | 10.1007/s00259-016-3433-2 | SDG/關鍵字: | erlotinib; fluorodeoxyglucose f 18; antineoplastic agent; erlotinib; fluorodeoxyglucose f 18; radiopharmaceutical agent; adult; aged; Article; bone metastasis; cancer patient; cancer survival; clinical article; computer assisted emission tomography; disease exacerbation; European Organization for Research and Treatment of Cancer criteria; female; human; image analysis; intermethod comparison; liver metastasis; lung adenocarcinoma; lung metastasis; lymph node metastasis; male; outcome assessment; overall survival; PET Response Criteria in Solid Tumors; PET-CT scanner; predictive value; progression free survival; response evaluation criteria in solid tumors; retrospective study; total lesion glycolysis measured using a systemic approach criteria; treatment outcome; treatment response; whole body PET; adenocarcinoma; Lung Neoplasms; middle aged; mortality; outcome assessment; positron emission tomography; procedures; prognosis; reproducibility; response evaluation criteria in solid tumors; secondary; sensitivity and specificity; standards; survival rate; very elderly; Adenocarcinoma; Adult; Aged; Aged, 80 and over; Antineoplastic Agents; Erlotinib Hydrochloride; Female; Fluorodeoxyglucose F18; Humans; Lung Neoplasms; Male; Middle Aged; Outcome Assessment (Health Care); Positron-Emission Tomography; Prognosis; Radiopharmaceuticals; Reproducibility of Results; Response Evaluation Criteria in Solid Tumors; Sensitivity and Specificity; Survival Rate; Treatment Outcome |
顯示於: | 生醫電子與資訊學研究所 |
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