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FDG PET/CT 显像在接受免疫治疗的淋巴瘤患者结局预测和疗效评估中的价值:一项 meta 分析和系统评价

英文原题:The value of FDG PET/CT imaging in outcome prediction and response assessment of lymphoma patients treated with immunotherapy: a meta-analysis and systematic review.

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The value of FDG PET/CT imaging in outcome prediction and response assessment of lymphoma patients treated with immunotherapy: a meta-analysis and systematic review.

PubMed 2022/08/06(内容时间) Eur J Nucl Med Mol Imaging Q1 · IF 7.6(JCR 2025)

研究概要

对于淋巴瘤的抗CD20治疗,作为基线18F-FDG PET/CT衍生参数的MTV对PFS和OS具有最高的HR。在抗CD20治疗中,早期和晚期反应评估中作为视觉标准的DS相比国际协调项目(IHP)视觉标准对PFS和OS具有更高的HR。18F-FDG PET参数的早期变化可能预测淋巴瘤患者对ICIs和细胞疗法的反应。

研究思路结论见上方概要

免疫治疗彻底改变了淋巴系统恶性肿瘤的治疗策略。由于霍奇金淋巴瘤和某些非霍奇金淋巴瘤亚型本身具有高度FDG亲和性肿瘤的特性,功能性18 F-FDG PET/CT显像已融入其常规诊疗。然而,问题在于,在这些肿瘤接受免疫治疗的背景下,它是否仍有价值。在此,我们将综述18 F-FDG PET/CT显像在接受免疫治疗方案治疗的淋巴系统肿瘤中的价值。

对PubMed数据库进行了全面文献检索,以评估18 F-FDG PET/CT在恶性淋巴瘤患者免疫治疗反应监测中的价值。符合以下所有纳入标准的文章被视为合格:(a) 针对不同类型恶性淋巴瘤患者的临床研究,(b) 接受抗CD20抗体、免疫检查点抑制剂或免疫细胞治疗,(c) 采用18 F-FDG作为PET示踪剂的PET/CT。

在最初确定的1488篇论文中,最终有91篇纳入我们的研究。在抗CD20治疗中,基线、早期和晚期反应监测参数对无进展生存期(PFS)的最高汇总风险比(HR)分别属于代谢肿瘤体积(MTV)(3.19(95%CI:2.36-4.30))、最大标准化摄取值(SUVmax)(3.25(95%CI:2.08-5.08))和Deauville评分(DS)(3.73(95%CI:2.50-5.56))。这些测量指标对总生存期(OS)的影响分别为MTV(4.39(95%CI:2.71-7.08))、DS(3.23(95%CI:1.87-5.58))和DS(3.64(95%CI:1.40-9.43))。在免疫检查点抑制剂(ICI)和免疫细胞治疗中,早期和晚期18 F-FDG PET/CT反应评估可能是预测临床结局的有效工具。

展开英文摘要原文

PURPOSE: Treatment strategies of lymphoid malignancies have been revolutionized by immunotherapy. Because of the inherent property of Hodgkin lymphoma and some subtypes of non-Hodgkin lymphoma as a highly FDG-avid tumor, functional 18 F-FDG PET/CT imaging is already embedded in their routine care. Nevertheless, the question is whether it is still valuable in the context of these tumors being treated with immunotherapy. Herein, we will review the value of 18 F-FDG PET/CT imaging lymphoid tumors treated with immunotherapy regimens. METHODS: A comprehensive literature search of the PubMed database was conducted on the value of the 18 F-FDG PET/CT for immunotherapy response monitoring of patients with malignant lymphoma. The articles were considered eligible if they met all of the following inclusion criteria: (a) clinical studies on patients with different types of malignant lymphoma, (b) treatment with anti-CD20 antibodies, immune checkpoint inhibitors or immune cell therapies, (c) and incorporated PET/CT with 18 F-FDG as the PET tracer. RESULTS: From the initial 1488 papers identified, 91 were ultimately included in our study. In anti-CD20 therapy, the highest pooled hazard ratios (HRs) of baseline, early, and late response monitoring parameters for progression-free survival (PFS) belong to metabolic tumor volume (MTV) (3.19 (95%CI: 2.36-4.30)), maximum standardized uptake value (SUVmax) (3.25 (95%CI: 2.08-5.08)), and Deauville score (DS) (3.73 (95%CI: 2.50-5.56)), respectively. These measurements for overall survival (OS) were MTV (4.39 (95%CI: 2.71-7.08)), DS (3.23 (95%CI: 1.87-5.58)), and DS (3.64 (95%CI: 1.40-9.43)), respectively. Early and late 18 F-FDG PET/CT response assessment in immune checkpoint inhibitors (ICI) and immune cell therapy might be an effective tool for prediction of clinical outcome. CONCLUSION: For anti-CD20 therapy of lymphoma, the MTV as a baseline 18 F-FDG PET/CT-derived parameter has the highest HRs for PFS and OS. The DS as visual criteria in early and late response assessment has higher HRs for PFS and OS compared to the international harmonization project (IHP) visual criteria in anti-CD20 therapy. Early changes in 18 F-FDG PET parameters may be predictive of response to ICIs and cell therapy in lymphoma patients.

论文信息

作者
Kiamanesh Z、Ayati N、Sadeghi R、Hawkes E、Lee ST、Scott AM
第一作者单位
Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.Iran
通讯作者单位
Olivia Newton-John Cancer Research Institute and School of Cancer Medicine, La Trobe University, Victoria, Australia. andrew.scott@austin.org.au.United States
文献类型
荟萃分析 · 系统综述
期刊
European journal of nuclear medicine and molecular imaging2022 Nov
原文标识
PubMed 35932329 · DOI 10.1007/s00259-022-05918-2