Effect of 18F-FDG PET/CT imaging and vascular endothelial growth factor in combination with autologous stem cell transplantation for POEMS syndrome
Objective To investigate the value of 18F-FDG PET/CT imaging and vascular endothelial growth factor(VEGF)in the radiochemotherapy combined with autologous stem cell transplantation treatment for POEMS syndrome.Methods A total of 123 patients'clinical and imaging data were retrospectively analyzed.The patients were clinically suspected of POEMS syndrome in the General Hospital of Northern Theater Command from June 2012 to December 2022.Eventually the study enrolled 25 patients.Among these,21 cases were clinically and pathologically diagnosed with POEMS syndrome,one case with indolent lymphoma,and three cases with multiple myeloma.The 21 patients with POEMS syndrome were divided into radiochemotherapy group(n=12)and radiochemotherapy combined with autologous stem cell transplantation group(n=9).Characteristics of PET/CT imaging,the maximum standardized uptake value(SUVmax),VEGF,interleukin-6(IL-6),free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH)levels of both groups were analyzed,and treatment efficacy was documented through follows-up.Results All 21 POEMS syndrome patients had varying degrees of polyneuropathy(21/21)and monoclonal plasma cell proliferative changes(21/21),10 case with skin changes.PET/CT imaging revealed morphological or metabolic abnormalities in 94 sites among the 21 patients.A positive correlation was found between SUVmax in 18F-FDG imaging and VEGF levels(r=0.590,P=0.005),whereas,there were no significant correlations between SUVmax and levels of FT3,FT4,TSH or IL-6(P>0.05).The average follows-up period was 55.5±17.6 months,and the post-treatment VEGF levels were significantly reduced compared to the pre-treatment baseline(1670.7±309.1 pg/mLvs 2051.0±458.8 pg/mL,P<0.05).The difference between median survival period in the radiochemotherapy combined with autologous stem cell transplantation group and radiochemotherapy group was not statistically significant(P=0.612).Conclusion PET/CT imaging combined with serum VEGF level could be used as a non-invasive method for the diagnosis,activity monitoring and prognosis assessment of POEMS syndrome.Autologous stem cells combined with chemoradiotherapy did not significantly prolong the median survival of POEMS syndrome.
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