纽约（路透社健康）12月22日－《临床肿瘤学》杂志12月第1期法国研究人员报道，对乳腺癌患者新辅助化疗肿瘤的反应进行预测，正电子发射断层摄影（PET）[输注18F氟脱氧葡萄糖（FDG）]是一种有效手段。
Rene Gauducheau中心的Caroline Rousseau博士，Saint Herblain及其同事们注意到，肿瘤代谢变化发生在肿瘤大小改变之前。研究表明，FDG摄入同其他方法相比会更及时反映出上述改变。研究人员对接受新辅助化疗的II期乳腺癌患者进行了研究。给药FDG后，分别于基线水平，化疗第一、第二、第三及第六疗程对患者进行PET成像。手术于第六疗程后进行，28名患者发现残留病变组织。该组中FDG标准值并未改变很多。然而，剩余的36名存在微小残留病变组织的患者中的34名，FDG标准摄入值同背景水平相比显著下降。利用基线标准摄入值的60%作为切断点，该方法的敏感性在化疗第一疗程后、第二疗程后、第三疗程后分别为61%、89%和88%。相应的特异性值分别为96%、95%和73%，阴性预测值为68%、85%和83%。
该结果表明，PET成像同超声及超声成像方法相比更优。事实上，利用任何一种方法对肿瘤反应进行评估，不管切断点如何选择，均有诊断意义。研究人员认为仍需更进一步研究，但当前研究已观察到，该方法能够对化疗第二疗程早期肿瘤反应提供有用信息。“肿瘤反应的早期信息，”他们总结道，“对治疗策略的最优选择非常有帮助。”
PET Scans Track Breast Cancer Response to Chemotherapy
NEW YORK (Reuters Health) Dec 22 - Positron emission tomography (PET) following infusion of [18F] fluorodeoxyglucose (FDG) is an effective means of predicting response to neoadjuvant chemotherapy in patients with breast cancer, French researchers report in the December 1st issue of the Journal of Clinical Oncology.
Dr. Caroline Rousseau of Centre Rene Gauducheau, Saint Herblain and colleagues note that changes in tumor metabolism take place before changes in tumor size. Studies have suggested that FDG uptake may reflect these changes sooner than is possible with other methods.
To investigate, the researchers studied stage II and II breast cancer patients who were receiving neoadjuvant chemotherapy. After administration of FDG, PET images were taken at baseline, and after the first, second third and sixth course of chemotherapy.
Surgery was performed after the 6th course and gross residual disease was seen in 28 patients. FDG standardized uptake values did not vary much in this group.
However, in 34 of the remaining 36 patients with minimal residual disease, values decreased markedly to background levels.
Using 60% of the baseline standardized uptake value as a cutoff point, the sensitivity of the approach was 61% after one course of chemotherapy, 89% after two and 88% after three. Corresponding values for specificity, were 96%, 95% and 73% and for negative predictive value, 68%, 85% and 83%.
This was considerable better than the results achieved using ultrasound or ultrasonography. In fact, assessment of tumor response using either of these modalities did reach significance regardless of the cutoff point chosen.
The researchers call for further studies, but observe that the approach can provide useful information on response as early as the second course of chemotherapy.
"Early information about tumor response," they conclude, "is extremely helpful in deciding the most appropriate therapeutic strategy."
J Clin Oncol 2006;24:5366-5372.
http://www.medscape.com/viewarticle/549832
编辑：蓝色幻想
