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18F-FDG PET-CT在Ⅲ~Ⅳ期滤泡性淋巴瘤疗效监测中的临床价值

Clinical value of 18F-FDG PET-CT to patients with follicular lymphoma staging Ⅲ-Ⅳ: monitoring response to therapy

摘要目的 探讨18F-FDG PET-CT对Ⅲ~Ⅳ期滤泡性淋巴瘤(FL)疗效监测的临床价值.方法 回顾性分析20例FL患者资料,所有患者在化疗前、化疗中及化疗后均行18F-FDG PET-CT检查,采用Kaplan-Meier方法对患者进行生存分析.结果 20例患者化疗中期PET-CT检查示14例完全缓解(CR),继续原方案化疗,化疗后PET-CT检查示患者均仍为CR,随访均未见复发.化疗中期PET-CT检查示2例部分缓解(PR),按原方案继续化疗,化疗后1例CR,1例进展(PD),随访均复发.化疗中期PET-CT检查示4例PD,均换化疗方案,化疗后2例CR,1例PR,1例PD,随访发现1例死亡,2例复发,1例CR.中位随访29个月,化疗中期PET-CT阴性预测值为100%(14/14),化疗中期PET-CT检查阳性组与阴性组无进展生存(PFS)比较,差异无统计学意义(24个月比32个月,P=0.135).化疗后PET-CT阴性预测值为88.2%(15/17),化疗后PET-CT阳性组与阴性组PFS比较,差异有统计学意义(8个月比34个月,P=0.0006).结论 18F-FDG PET-CT能有效地监测Ⅲ~Ⅳ期FL化疗疗效,并有助于临床制定个体化治疗方案.

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abstractsObjective To evaluate the clinical value of 18F-FDG PET-CT in monitoring response to therapy in patients with follicular lymphoma (FL) staging Ⅲ-Ⅳ.Methods The clinical data of 20 patients with FL were analyzed retrospectively.All patients underwent PET-CT at three times:baseline,after 3-4 cycles of chemotherapy,and end of treatment.Kaplan-Meier method was used to analyze the survival of patients.Results 14 patients achieved CR at the interim PET-CT,all patients achieved CR at post therapy PET-CT:all patients were alive with no evidence of disease in the follow-up.2 patiens achieved PR at the interim PET-CT,and 1 patient achieved CR,and 1 patient was PD,at post therapy PET-CT,all patients were relapsed in the follow-up.4 patients achieved PD,and all patients were changed the chemotherapy plan.At post therapy PET-CT,2 patients achieved CR,1 patient achieved PR,and 1 patient was PD,1 patient was no evidence of disease,2 patients were relapsed,and another was died in the follow-up.The negative predictive values (NPV) of the interim and the post therapy PET-CT were 100 % (14/14),88.2 % (15/17) respectively.The interim PET-CT was no significantly correlated with PFS (P =0.135),while the post therapy PET-CT was significantly correlated with PFS (P =0.0006).Conclusion 18F-FDG PET-CT is useful to monitor response to chemotherapy in patients with FL staging Ⅲ-Ⅳ,and set personalized treatment plan.

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