Predicción de la respuesta completa a la quimiorradioterapia neoadyuvante en el cáncer de recto localmente avanzado: papel de los parámetros volumétricos basales de la PET/TC con [18F]FDG y los marcadores inflamatorios

IF 1.6 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Revista Espanola De Medicina Nuclear E Imagen Molecular Pub Date : 2025-06-02 DOI:10.1016/j.remn.2025.500113

G.U. Erdem , O. Vural Topuz , E. Acar , T. Kapagan , E. Yetim , A. Ozmen , S. Gurocak , G. Usul , S. Yuksel , A.H. Yardimci , N. Bulut

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引用次数: 0

Abstract

Objectives

We evaluated the influence of baseline volumetric 18F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) parameters and inflammatory prognostic markers on complete response (CR) in patients with locally advanced rectal cancer (LARC) treated with neoadjuvant chemoradiotherapy (nCRT).

Materials and methods

In total, 90 patients with LARC, including those with and without CR, were evaluated based on baseline volumetric PET/CT parameters, such as maximum standard uptake value, metabolic tumor volume (MTV), tumor lesion glycolysis, and inflammatory prognostic markers, including the lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio.

Results

Of the 90 patients, 62 (68.9%) were male and 28 (31.1%) were female. The median age was 61 (31-81) years. A complete response was observed in 20 (22%) patients following nCRT. Of these, 5 demonstrated a clinical complete response, whereas 15 exhibited a complete response after surgery. A low pretreatment PLR, low MTV levels, and stage 2 disease were identified as significant predictors of complete response. The optimal cutoff values were 16.5 for MTV (sensitivity 80%, specificity 62%) and 121 for PLR (sensitivity 73%, specificity 65%).

Conclusion

Our findings suggest that stage 2 disease, low pretreatment MTV, and low PLR levels may be predictive of a CR to nCRT in patients with LARC.

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预测局部晚期直肠癌新辅助化疗的完全反应：使用[18F]FDG和炎症标志物的PET/ CT基本体积参数的作用

目的评估基线容量18f -氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（18F-FDG PET/CT）参数和炎症预后标志物对局部晚期直肠癌（LARC）接受新辅助放化疗（nCRT）患者完全缓解（CR）的影响。材料和方法共90例LARC患者，包括伴有和不伴有CR的患者，根据PET/CT的基线体积参数进行评估，如最大标准摄取值、代谢肿瘤体积（MTV）、肿瘤病变糖酵解和炎症预后指标，包括淋巴细胞与单核细胞比值、血小板与淋巴细胞比值（PLR）和中性粒细胞与淋巴细胞比值。结果90例患者中，男性62例（68.9%），女性28例（31.1%）。中位年龄为61岁（31-81岁）。20例（22%）患者在nCRT后完全缓解。其中5例临床完全缓解，15例术后完全缓解。低预处理PLR、低MTV水平和2期疾病被认为是完全缓解的重要预测因素。MTV的最佳截止值为16.5（灵敏度80%，特异性62%），PLR的最佳截止值为121（灵敏度73%，特异性65%）。结论我们的研究结果表明，2期疾病、低预处理MTV和低PLR水平可能预示着LARC患者的CR到nCRT。

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

Revista Espanola De Medicina Nuclear E Imagen Molecular RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

1.10

自引率

16.70%

发文量

审稿时长

24 days

期刊介绍： The Revista Española de Medicina Nuclear e Imagen Molecular (Spanish Journal of Nuclear Medicine and Molecular Imaging), was founded in 1982, and is the official journal of the Spanish Society of Nuclear Medicine and Molecular Imaging, which has more than 700 members. The Journal, which publishes 6 regular issues per year, has the promotion of research and continuing education in all fields of Nuclear Medicine as its main aim. For this, its principal sections are Originals, Clinical Notes, Images of Interest, and Special Collaboration articles.