文章：

比较确定局部晚期宫颈癌患者放化疗后完全缓解的方法

Comparing Methods to Determine Complete Response to Chemoradiation in Patients with Locally Advanced Cervical Cancer

原文发布日期：31 December 2023

DOI: 10.3390/cancers16010198

类型: Article

开放获取: 是

英文摘要：

Objectives: There is no consensus on the most reliable procedure to determine remission of cervical cancer after chemoradiotherapy (CRT). Therefore, this study aims to assess the diagnostic performance of two different imaging techniques, MRI and 18F[FDG]-PET/CT, in determining the presence of locoregional residual disease after CRT in patients with locally advanced cervical cancer. Methods: Patients diagnosed with locally advanced cervical cancer (FIGO 2009) treated with CRT were retrospectively identified from a regional cohort. The accuracy of MRI and 18F[FDG]-PET/CT in detecting locoregional residual disease was assessed with histology as the reference standard. Results: The negative predictive value (NPV) and positive predictive value (PPV) for locoregional residual disease detection of MRI and 18F[FDG]-PET/CT combined were 84.2% (95% CI 73.2–92.1), and 70.4% (95% CI 51.8–85.2), respectively. The NPV and PPV of MRI alone were 80.2% (95% CI 71.2–87.5) and 47.7% (95% CI 35.8–59.7), respectively, and values of 81.1% (95% CI 72.2–88.3) and 55.8 (95% CI 42.2–68.7), respectively, were obtained for 18F[FDG]-PET/CT alone. Conclusion: In this study, the reliability of MRI and 18F[FDG]-PET/CT in detecting locoregional residual disease was limited. Combining MRI and 18F[FDG]-PET/CT did not improve predictive values. Routine use of both MRI and 18F[FDG]-PET/CT in the follow-up after CRT should be avoided. MRI during follow-up is the advised imaging technique. Pathology confirmation of the presence of locoregional residual disease before performing salvage surgery is warranted.

摘要翻译： 

目的：目前对于确定宫颈癌放化疗后缓解状态的最可靠方法尚无共识。本研究旨在评估磁共振成像与18F[FDG]-PET/CT两种影像学技术对局部晚期宫颈癌患者放化疗后区域残留病灶的诊断效能。方法：从区域性队列中回顾性纳入经放化疗治疗的局部晚期宫颈癌患者（FIGO 2009分期）。以组织病理学为金标准，评估MRI与18F[FDG]-PET/CT检测区域残留病灶的准确性。结果：MRI联合18F[FDG]-PET/CT检测区域残留病灶的阴性预测值与阳性预测值分别为84.2%（95%CI 73.2-92.1）和70.4%（95%CI 51.8-85.2）。单独使用MRI的阴性预测值与阳性预测值分别为80.2%（95%CI 71.2-87.5）和47.7%（95%CI 35.8-59.7），而单独使用18F[FDG]-PET/CT的对应值分别为81.1%（95%CI 72.2-88.3）和55.8%（95%CI 42.2-68.7）。结论：本研究表明MRI与18F[FDG]-PET/CT检测区域残留病灶的可靠性有限，联合使用两种影像学技术并未提升预测效能。应避免在放化疗后随访中常规联合使用MRI与18F[FDG]-PET/CT，建议将MRI作为随访期间的影像学检查手段。在进行挽救性手术前，必须通过病理学检查确认区域残留病灶的存在。

原文链接：

Comparing Methods to Determine Complete Response to Chemoradiation in Patients with Locally Advanced Cervical Cancer