Tumour and adipose tissue uptake on 18F-Fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) predict immunotherapy response in recurrent or metastatic nasopharyngeal carcinoma

IF 2.1 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology Pub Date : 2025-05-14 DOI:10.1016/j.crad.2025.106959

J. Bao , M. Xiong , M. Zheng , P. Huang , X. Lin

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Abstract

AIM

This study evaluated the prognostic value of ¹⁸F-Fluorodeoxyglucose (¹⁸F-FDG) uptake in tumour and adipose tissue in recurrent or metastatic (R/M) nasopharyngeal carcinoma (NPC) patients treated with immunotherapy.

MATERIALS AND METHODS

We retrospectively included 120 patients with R/M NPC treated with PD-1 inhibitors. Maximum standardised uptake value (SUV_max), metabolic tumour volume (MTV), and total lesion glycolysis (TLG) of all malignant lesions were recorded. Additionally, SUV_max and SUV_mean were measured for subcutaneous and visceral adipose tissue (SAT and VAT). The study classified patients who, within six months of immunotherapy, either experienced tumour progression, died, or changed treatment regimens as the nonclinical benefit (non-CB) group, and others as the CB group. The primary endpoints were progression-free survival (PFS) and overall survival (OS).

RESULTS

The CB group had significantly lower primary tumour MTV (PT-MTV) (median, 15.8 vs 48.1, P=0.006), PT-TLG (median, 88.7 vs 275.6, P=0.008) and SUV_max-VAT (median, 0.63 vs 0.77, P=0.047) than non-CB group. More T4 stages (71.4% vs. 41.3%) and lung metastases (42.9% vs 21.7%) were observed in the non-CB group compared to the CB group. Multivariate analysis indicated lung metastases (P=0.002, hazard ratio [HR] = 2.204, 95% confidence interval [CI]: 1.323–3.669) and higher primary tumour burden (P<0.001, HR= 3.379, 95% CI: 1.768–6.460) as independent PFS predictors. Only higher primary tumour burden (P=0.027, HR=2.513, 95% CI: 1.108–5.698) was an independent OS predictor.

CONCLUSION

Our study indicates that higher primary tumour burden is associated with poor prognosis for NPC patients undergoing immunotherapy. SUV_max-VAT may be a promising predictor for immunotherapy response.

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肿瘤和脂肪组织对18f -氟脱氧葡萄糖（18F-FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）的摄取预测复发或转移性鼻咽癌的免疫治疗反应

目的：本研究评估经免疫治疗的复发或转移（R/M）鼻咽癌（NPC）患者肿瘤和脂肪组织中18f -氟脱氧葡萄糖（18F-FDG）摄取的预后价值。材料与方法我们回顾性纳入120例接受PD-1抑制剂治疗的R/M型鼻咽癌患者。记录所有恶性病变的最大标准化摄取值（SUVmax）、代谢肿瘤体积（MTV）和病变总糖酵解（TLG）。此外，测量皮下和内脏脂肪组织（SAT和VAT）的SUVmax和SUVmean。该研究将在免疫治疗6个月内出现肿瘤进展、死亡或改变治疗方案的患者分类为非临床获益组（non- clinical benefit, non-CB），其他患者分类为CB组。主要终点为无进展生存期（PFS）和总生存期（OS）。结果CB组原发性肿瘤MTV (PT-MTV)（中位数，15.8 vs 48.1， P=0.006）、PT-TLG（中位数，88.7 vs 275.6， P=0.008）和SUVmax-VAT（中位数，0.63 vs 0.77， P=0.047）均显著低于非CB组。与CB组相比，非CB组观察到更多的T4分期（71.4%对41.3%）和肺转移（42.9%对21.7%）。多因素分析显示，肺转移（P=0.002，风险比[HR] = 2.204, 95%可信区间[CI]: 1.323-3.669）和较高的原发肿瘤负担（P<0.001， HR= 3.379, 95% CI: 1.768-6.460）是PFS的独立预测因子。只有较高的原发肿瘤负担（P=0.027， HR=2.513, 95% CI: 1.108-5.698）是独立的OS预测因子。结论原发性肿瘤负担加重与免疫治疗鼻咽癌患者预后不良相关。SUVmax-VAT可能是免疫治疗反应的一个有希望的预测指标。

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

Clinical radiology 医学-核医学

CiteScore

4.70

自引率

3.80%

发文量

528

审稿时长

76 days

期刊介绍： Clinical Radiology is published by Elsevier on behalf of The Royal College of Radiologists. Clinical Radiology is an International Journal bringing you original research, editorials and review articles on all aspects of diagnostic imaging, including: • Computed tomography • Magnetic resonance imaging • Ultrasonography • Digital radiology • Interventional radiology • Radiography • Nuclear medicine Papers on radiological protection, quality assurance, audit in radiology and matters relating to radiological training and education are also included. In addition, each issue contains correspondence, book reviews and notices of forthcoming events.