^(18)F-FDGPET/CT评估贝伐珠单抗联合化疗治疗晚期非小细胞肺癌的疗效研究

Study of ^(18)F-FDG PET/CT in the Evaluation of Efficacy of Bevacizumab Combined with Chemotherapy on Advanced Non-small Cell lung Cancer

目的研究^(18)F-FDG PET/CT用于贝伐珠单抗联合化疗治疗晚期非小细胞肺癌(NSCLC)疗效评估的价值。方法选取2014年3月至2016年3月我院晚期NSCLC患者81例进行前瞻性研究,均接受以铂类为基础的联合化疗和贝伐珠单抗治疗,分别于治疗前及治疗第1、2个周期后1周内行18F-FDG PET/CT检查,比较^(18)F-FDG PET/CT和CT对治疗效果和预后判断的准确性。结果治疗第1个周期时PET/CT检查显示代谢有效率为60.49%,CT扫描显示客观有效率为44.32%;两种检查方法一致性Kappa值为0.446,Mc Nemar检验结果显示差异有统计学意义(P<0.05);治疗第2个周期时,PET/CT显示代谢有效率为75.31%,CT扫描显示客观有效率为69.14%,两种方法一致性Kappa值为0.546,Mc Nemar检验显示未见明显差异(P>0.05);随访结果显示81例患者3年生存率为34.57%,其中CMR+PMR患者中位OS为35(31.3~38.7)个月,SMD+PMD患者中位OS为26(20.6~31.4)个月,两组比较差异有统计学意义(P<0.05);CR+PR患者中位OS为34(30.9~37.1)个月,SD+PD患者中位OS为31(25.2~36.8)个月,两组比较未见明显差异(P>0.05)。结论 ^(18)F-FDG PET/CT用于贝伐珠单抗联合化疗治疗晚期NSCLC疗效评估较CT更为及时和准确,同时还能有效判断患者预后情况,在临床治疗中具有重要参考价值。

Objective To study the value of ^(18)F-FDG PET/CT in the evaluation of efficacy of bevacizumab combined with chemotherapy on advanced non-small cell lung cancer(NSCLC).Methods A prospective study was performed on 81 patients with advanced NSCLC from March 2014 to March 2016 in our hospital.All patients received platinum-based combination chemotherapy and bevacizumab treatment before treatment and treatment.^(18)F-FDG PET/CT was performed before treatment and within 1 week after 1 cycle and 2 cycles of treatment,and the accuracies of ^(18)F-FDG PET/CT and CT on treatment effects and prognosis evaluation were compared.Results At 1 cycle of treatment,PET/CT showed a metabolic effective rate of 60.49%,and CT scan showed an objective effective rate of 44.32%.The consistency Kappa value of the two methods was 0.446,and Mc Nemar test showed statistically significant differences(P<0.05).At 2 cycles of treatment,PET/CT showed a metabolic effective rate of 75.31%,and CT scan showed an objective effective rate of 69.14%,and the consistency Kappa value of the two methods was 0.546,and Mc Nemar test showed no significant difference(P>0.05).Follow-up results showed that the 3 year survival rate of 81 patients was 34.57%,and the median OS of patients with CMR+PMR was 35(31.3 to 38.7)months,and the median OS of SMD+PMD patients was 26(20.6 to 31.4)months,and the difference between the two groups was statistically significant(P<0.05).The median OS of CR+PR patients was 34(30.9 to 37.1)months,and the median OS of SD+PD patients was 31(25.2 to 36.8)months,and there was no significant difference between the two groups(P>0.05).Conclusion ^(18)F-FDG PET/CT is a more timely and accurate evaluation of efficacy of bevacizumab combined with chemotherapy in the treatment of advanced NSCLC than CT.It can also effectively judge the prognosis of patients and has important reference value in clinical treatment.