Prognostic value of baseline 18F-FDG PET/CT metabolic parameters in locally advanced cervical cancer after concurrent chemoradiotherapy
Objective To explore the prognostic value of baseline 18F-FDG PET/CT metabolic pa-rameters in locally advanced cervical cancer(LACC)after concurrent chemoradiotherapy(CCRT).Meth-ods From September 2015 to October 2021,the clinical data of 180 LACC patients(age:22-76 years)who underwent 18F-FDG PET/CT before CCRT at Affiliated Cancer Hospital of Shandong First Medical Uni-versity were analyzed retrospectively.The metabolic tumor volume(MTV),total lesion glycolysis(TLG),SUVmax,and SUVmean were computed by using the margin threshold of 42％SUVmax.The optimal threshold for predicting progression-free survival(PFS)was obtained by ROC curve analysis.The Kaplan-Meier method was applied for survival analysis,and the log-rank test was applied to compare the survival rate between groups.Multivariate Cox proportional hazard regression was used to analyze progression for PFS.Results The median follow-up was 19.1 months,and 54 patients(30.0％,54/180)suffered from disease progression.ROC curve analysis showed that the optimal cut-off value of MTV was 31.145 ml,with the AUC of 0.641.Para-aortic lymph node(PALN)metastasis had the highest AUC value(0.589)among the clinical factors,followed by International Federation of Gynecology and Obstetrics(FIGO)stage(0.581).The 1-year PFS rates of patients with MTV＜31.145 ml(n=88)and MTV≥31.145 ml(n=92)were 80.68％and 59.78％,respectively(x2=13.72,P＜0.001).Multivariate Cox analysis demonstrated that pathological type(hazard ratio(HR)=3.075,95％CI:1.370-6.901,P=0.006),FIGO stage(HR=1.955,95％CI:1.031-3.707,P=0.040),PALN metastasis(HR=2.136,95％CI:1.202-3.796,P=0.010)and MTV(HR=2.449,95％CI:1.341-4.471,P=0.004)were the significant predictors for PFS.Conclusions Patho-logical type,FIGO stage,PALN metastasis and MTV are independent prognostic risk factors for PFS.MTV as the baseline 18F-FDG PET/CT metabolic parameter,can realize prognostic stratification analysis.
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