The role of baseline 18F-FDG PET/CT for survival prognosis in NSCLC patients undergoing immunotherapy: a systematic review and meta-analysis.

IF 4.3 2区 医学 Q2 ONCOLOGY
Therapeutic Advances in Medical Oncology Pub Date : 2024-11-04 eCollection Date: 2024-01-01 DOI:10.1177/17588359241293364
Mingxing Huang, Yuheng Zou, Weichen Wang, Qianrui Li, Rong Tian
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引用次数: 0

Abstract

Background: The value of pretreatment baseline 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET)/computed tomography (CT) as a prognostic factor for survival of patients with non-small-cell lung cancer (NSCLC) receiving immunotherapy remained uncertain.

Objectives: To investigate the prognostic ability of baseline 18F-FDG PET/CT in patients with NSCLC receiving immunotherapy.

Design: A systematic review and meta-analysis.

Data sources and methods: We searched the PubMed, EMBASE, and Cochrane Central Register of Controlled Trials databases until May 7, 2024, and extracted data related to patient characteristics, semiquantitative parameters of 18F-FDG PET/CT, and survival. We pooled hazard ratios (HRs) to evaluate the prognostic value of the maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) for overall survival (OS) and progression-free survival (PFS).

Results: A total of 22 studies (1363 patients, average age range 30-88 years) were included. Baseline 18F-FDG PET/CT-derived MTV was significantly associated with both OS (HR: 1.124, 95% confidence interval (CI) 1.058-1.195, I 2 = 81.70%) and PFS (HR: 1.069, 95% CI: 1.016-1.124, I 2 = 71.80%). Other baseline 18F-FDG PET/CT-derived parameters, including SUVmax (OS: HR: 0.930, 95% CI: 0.718-1.230; PFS: HR: 0.979, 95% CI: 0.759-1.262), SUVmean (OS: HR: 0.801, 95% CI: 0.549-1.170; PFS: HR: 0.688, 95% CI: 0.464-1.020), and TLG (OS: HR: 0.999, 95% CI: 0.980-1.018; PFS: HR: 0.995, 95% CI: 0.980-1.010), were not associated with survival. Sensitivity analyses by removing one study at a time did not significantly alter the association between MTV and PFS or between MTV and OS. There was no evidence of publication bias.

Conclusion: Pretreatment baseline 18F-FDG PET/CT-derived MTV might be a prognostic biomarker in NSCLC patients receiving immunotherapy. Further studies are needed to support routine use.

基线18F-FDG PET/CT对接受免疫疗法的NSCLC患者生存预后的作用:系统综述和荟萃分析。
背景:治疗前基线18F-氟脱氧葡萄糖正电子发射断层扫描(18F-FDG PET)/计算机断层扫描(CT)作为接受免疫治疗的非小细胞肺癌(NSCLC)患者生存预后因素的价值仍不确定:研究接受免疫治疗的非小细胞肺癌患者基线18F-FDG PET/CT的预后能力:设计:系统综述和荟萃分析:我们检索了截至2024年5月7日的PubMed、EMBASE和Cochrane Central Register of Controlled Trials数据库,并提取了与患者特征、18F-FDG PET/CT半定量参数和生存相关的数据。我们汇总了危险比(HRs),以评估最大标准化摄取值(SUVmax)、平均标准化摄取值(SUVmean)、代谢肿瘤体积(MTV)和病变总糖酵解(TLG)对总生存期(OS)和无进展生存期(PFS)的预后价值:共纳入 22 项研究(1363 名患者,平均年龄 30-88 岁)。基线 18F-FDG PET/CT 衍生 MTV 与 OS(HR:1.124,95% 置信区间 (CI):1.058-1.195,I 2 = 81.70%)和 PFS(HR:1.069,95% CI:1.016-1.124,I 2 = 71.80%)显著相关。其他基线 18F-FDG PET/CT 衍生参数包括 SUVmax(OS:HR:0.930,95% CI:0.718-1.230;PFS:HR:0.979,95% CI:0.759-1.262)、SUVmean(OS:HR:0.801,95% CI:0.549-1.170;PFS:HR:0.688,95% CI:0.464-1.020)和 TLG(OS:HR:0.999,95% CI:0.980-1.018;PFS:HR:0.995,95% CI:0.980-1.010)与生存率无关。通过每次移除一项研究的敏感性分析并未显著改变MTV与PFS或MTV与OS之间的关系。没有证据表明存在发表偏倚:结论:治疗前基线18F-FDG PET/CT衍生的MTV可能是接受免疫治疗的NSCLC患者的预后生物标志物。需要进一步的研究来支持常规使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
8.20
自引率
2.00%
发文量
160
审稿时长
15 weeks
期刊介绍: Therapeutic Advances in Medical Oncology is an open access, peer-reviewed journal delivering the highest quality articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of cancer. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in medical oncology, providing a forum in print and online for publishing the highest quality articles in this area. This journal is a member of the Committee on Publication Ethics (COPE).
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