- 作者：Jieun Lee ; Jung Oh Kim ; Chan Kwon Jung ; Yeon Shil Kim ; Ie Ryung Yoo ; Woo Hee Choi ; Eun Kyung Jeon ; Suk Hee Hong ; Sang Hoon Chun ; Seung Joon Kim ; Young Kyoon Kim ; Jin Hyoung Kang
- 关键词：Bcl-2 ; FDG-PET ; GLUT-1 ; HIF-1伪 ; Small-Cell Lung Cancer
- 刊名：Clinical Lung Cancer
- 出版年：March, 2014
- 年：2014
- 卷：15
- 期：2
- 页码：e13-e21
- 全文大小：756 K
Background
Limited disease small-cell lung cancer responds well to concurrent chemoradiation therapy (CCRT), but shows high relapse rate and short RFS. We aimed to evaluate tumor metabolic activities measured using FDG-PET as a prognostic factor and analyze its relationships with markers of tumor biologic behavior.Patients and Methods
Forty-one LD-SCLC patients receiving 4 cycles of EP (etoposide 120 mg/m2, days 1-3; cisplatin 60 mg/m2, day 1), 2 cycles of EP (etoposide 130 mg/m2, days 1-3; cisplatin 30 mg/m2, day 1)-CCRT were enrolled. Maximum standardized uptake value (SUV; SUVmax) of primary tumor was revised with SUV of liver (SUVlivermax). Differences between pre-, posttreatment average SUV uptake of primary tumor, and intrathoracic lymph nodes were presented as 螖SUVliveravg. Thirty-one tumor biopsy specimens were immunostained for GLUT-1, Bcl-2, and HIF-1伪.
Results
The median overall survival (OS), and RFS were 13.7 and 10.4 months, respectively. In multivariate analysis, pretreatment lactate dehydrogenase (LDH) and 螖SUVliveravg correlated with RFS (hazard ratio [HR], 2.8, P聽= .043; HR, 0.3, P聽= .004). Sex, LDH, objective tumor metabolic response, and SUVlivermax correlated with OS (HR, 12.1, P聽= .006; HR, 3.7, P聽= .037; HR, 10.1, P聽=聽.008; and HR, 0.2, P聽= .014, respectively). High GLUT-1 positivity (> 75%), and LDH level (> 400 U/L) correlated with聽better objective response rate (P聽= .012) and HIF-1伪 immunoreactivity score (P聽= .029).
Conclusion
螖SUVliveravg and GLUT-1 expression might predict RFS and ORR in patients with LD-SCLC treated with definitive CCRT.