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DOI: 10.1055/s-0029-1237531
© Georg Thieme Verlag KG Stuttgart · New York
Positronen-Emissions-Tomographie zur Vorhersage des Therapieansprechens bei Weichteilsarkomen
Positron emission tomography as a tool for early prediction of therapy outcome in soft tissue sarcomaPublikationsverlauf
eingereicht: 16.3.2009
akzeptiert: 25.6.2009
Publikationsdatum:
16. September 2009 (online)

Zusammenfassung
Hintergrund und Fragestellung: Bei Patienten mit Weichteilsarkomen wurden therapiebedingte Veränderungen in der Positronen-Emissions-Tomographie (PET) mit 2-Deoxy-2-[18 F]Fluoro-D-Glucose (FDG) im Hinblick auf eine frühzeitige Vorhersage des therapeutischen Erfolges evaluiert.
Patienten und Methodik: 35 Patienten mit Hochrisiko-Weichteilsarkomen wurden mit einer Chemotherapie aus Doxorubicin, Ifosfamid (AI-G-Schema) oder Etoposid, Ifosfamid und Doxorubicin (EIA-Schema) behandelt. Jeweils vor Therapiebeginn sowie nach einem Zyklus AI-G bzw. zwei Zyklen EIA fand eine PET statt. Als Hinweis auf ein Ansprechen wurde der in der PET ermittelte „standardized uptake value” (SUV) herangezogen. Als Referenz diente die Verlaufskontrolle gemäß den „Response Evaluation Criteria in Solid Tumours” (RECIST); sie erfolgte nach 6 Zyklen AI-G bzw. 4 Zyklen EIA Chemotherapie.
Ergebnisse: Bei 2 Patienten kam es zu einer kompletten Remission (NED), bei 11 Patienten zu einer partiellen Remission (PR), 17 Patienten wiesen eine stabile Erkrankung (SD) und 5 eine Krankheitsprogression (PD) auf. Bei einer Abnahme des SUV-Wertes (Responder) konnte ein Trend hinsichtlich eines längeren krankheitsfreien Überlebens gezeigt werden, im Vergleich zu Patienten mit einer Zunahme oder einem stabilem SUV-Wert (Non-Responder) (p = 0,0943).
Folgerung: Auf der Basis dieser Daten erscheint eine frühzeitige Vorhersage der Chemosensitivität des Tumors sowie des Therapieerfolges möglich.
Summary
Background and objective: We used 2-deoxy-2-[18 F] fluoro-D-glucose (FDG) positron emission tomography (PET) to evaluate the FDG uptake in patients with soft tissue sarcoma (STS). Treatment effect was assessed with regard to prediction of therapy outcome.
Patients and methods: This evaluation includes 35 patients with high risk STS receiving chemotherapy consisting of doxorubicin and ifosfamide (AI-G regimen) or etoposide, ifosfamide and doxorubicin (EIA regimen). Patients were examined using PET prior to onset of therapy and after completion of the first cycle of AI-G and after two cycles of EIA chemotherapy, respectively. Restaging according to RECIST was performed after six cycles of AI-G or four cycles of EIA chemotherapy and served as reference.
Results: Clinical outcome of 35 evaluable patients was as follows: two patients with no evidence of disease (NED), eleven with partial remission (PR), 17 with stable disease (SD), and five patients with progressive disease (PD). A difference regarding progression-free survival for patients with a decrease in SUV (responders) in comparison to patients with an increase or stable SUV (non-responders) could be demonstrated (p = 0.0943 ).
Conclusion: On the basis of these data, prediction of chemo-sensitivity of the tumour and moreover of the therapy outcome might be possible.
Schlüsselwörter
Fluorodeoxyglucose - Positronen-Emissions-Tomographie - RECIST-Kriterien - Weichteilsarkome
Keywords
fluorodeoxyglucose - positron emission tomography - RECIST criteria - soft tissue sarcoma
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Priv.-Doz. Dr. med. Bernd Kasper
Universitätsklinikum Heidelberg, Innere
Medizin V, Hämatologie/Onkologie
Im
Neuenheimer Feld 410
69120 Heidelberg
Telefon: 06221-56-8008
Fax: 06221-56-6824
eMail: mail@berndkasper.de