Early response evaluation using 18F-FDG-PET/CT does not influence management of patients with metastatic gastrointestinal stromal tumors (GIST) treated with palliative intent.
Sheima Farag, Nikki S IJzerman, Matthijs P M Houdijk, An K L Reyners, Anne Ij Arens, Dirk J Grünhagen, Ingrid M E Desar, Hans Gelderblom, Neeltje Steeghs, Lioe-Fee de Geus-Oei
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引用次数: 1
Abstract
Aim: The aim of this study was to investigate the impact of 18F-FDG-PET/CT on treatment decision making in metastatic gastrointestinal stromal tumor (GIST) patients.
Methods: This study retrospectively evaluated 18F-FDG-PET/CT scans to monitor response of metastatic GIST patients treated with palliative intent. Data from the Dutch GIST Registry was used. Early scans (<10 weeks after start of treatment) and late scans (>10 weeks after start of treatment) were scored on the impact in change of treatment.
Results: Sixty-one PET/CT scans were performed for treatment evaluation in 39 patients with metastatic GIST of which 36 were early scans and 25 were late scans. Early PET/CT scans led to a change in management in 5.6% of patients and late PET/CT scans led to a change in management in 56% of patients. Change in management was more often seen after scans with lack of metabolic response (48% vs. 11% in scans with metabolic response, p=0.002). Neither metabolic response nor change in treatment were more often seen in patients with KIT mutations compared to patients with non-KIT mutations (metabolic response 65% KIT vs. 46% non-KIT, p=0.33, and change in management 28% KIT vs. 21% non-KIT, p=0.74).
Conclusion: 18F-FDG-PET/CT is not recommended for early response evaluation in an unselected patient population with metastatic GIST, since it does not influence treatment decisions. 18F-FDG-PET/CT, however, can be useful for late response assessment, especially in case of indeterminate CT results.
目的:本研究旨在探讨18F-FDG-PET/CT对转移性胃肠道间质瘤(GIST)患者治疗决策的影响。方法:本研究回顾性评估18F-FDG-PET/CT扫描监测转移性GIST患者姑息治疗的反应。数据来自荷兰GIST登记处。早期扫描(治疗开始后10周)对治疗变化的影响进行评分。结果:39例转移性GIST患者进行了61次PET/CT扫描进行治疗评估,其中36例为早期扫描,25例为晚期扫描。早期PET/CT扫描导致5.6%的患者管理发生变化,晚期PET/CT扫描导致56%的患者管理发生变化。治疗方法的改变在缺乏代谢反应的扫描后更为常见(48%对11%的代谢反应扫描,p=0.002)。与非KIT突变患者相比,KIT突变患者的代谢反应和治疗变化都不常见(代谢反应65% KIT vs 46%非KIT, p=0.33,管理变化28% KIT vs 21%非KIT, p=0.74)。结论:18F-FDG-PET/CT不推荐用于未选择的转移性GIST患者群体的早期反应评估,因为它不影响治疗决策。然而,18F-FDG-PET/CT可用于晚期反应评估,特别是在CT结果不确定的情况下。
期刊介绍:
Als Standes- und Fachorgan (Organ von Deutscher Gesellschaft für Nuklearmedizin (DGN), Österreichischer Gesellschaft für Nuklearmedizin und Molekulare Bildgebung (ÖGN), Schweizerischer Gesellschaft für Nuklearmedizin (SGNM, SSNM)) von hohem wissenschaftlichen Anspruch befasst sich die CME-zertifizierte Nuklearmedizin/ NuclearMedicine mit Diagnostik und Therapie in der Nuklearmedizin und dem Strahlenschutz: Originalien, Übersichtsarbeiten, Referate und Kongressberichte stellen aktuelle Themen der Diagnose und Therapie dar.
Ausführliche Berichte aus den DGN-Arbeitskreisen, Nachrichten aus Forschung und Industrie sowie Beschreibungen innovativer technischer Geräte, Einrichtungen und Systeme runden das Konzept ab.
Die Abstracts der Jahrestagungen dreier europäischer Fachgesellschaften sind Bestandteil der Kongressausgaben.
Nuklearmedizin erscheint regelmäßig mit sechs Ausgaben pro Jahr und richtet sich vor allem an Nuklearmediziner, Radiologen, Strahlentherapeuten, Medizinphysiker und Radiopharmazeuten.