Prädiktion der Operabilität und des Outcomes von Patienten mit nicht-kleinzelligem Lungenkarzinom mittels der integrierten [18F] FDG-PET/CT
Auch gedruckt in der BibliothekZ: J-H 13.408; W: W-H 11.846
Ressourcen- / MedientypDissertation, Text
Datum der Freischaltung2009-10-30
Fast and accurate staging is essential for choosing treatment for NSCLC. The purpose of this prospective, non-randomized trial was to evaluate the reliability of PET/CT for staging of NSCLC compared to CT and PET alone and the ability of PET/CT in clinical decision making for further individual treatment dependent on UICC. 267 patients with suspected NSCLC were examined using PET/CT. A biopsy was performed on all patients. 185 patients showed NSCLC: 80 patients underwent surgery (pathologic staging), 105 patients maintained chemotherapy and/or radiotherapy. Imaging modalities were evaluated independently. The patients were divided into 2 groups: curative surgery (UICC <= IIIA) vs. futile surgery (palliative situation; UICC > IIIA). Follow-up data for all patients were obtained. Endpoint was death of any cause. In 80 operated NSCLC-patients the accuracy of CT, PET and PET/CT in T-staging was 66.3 %, 70.0 % and 80.0 %, respectively. PET/CT was significantly superior (p < 0.05). In N-staging the accuracy of CT was 45.0 %, of PET 67.5 % and of PET/CT 73.8 %, respectively. PET/CT was significantly superior to CT alone (p < 0.05). There was no significant difference compared to PET alone (p > 0.05). The median follow-up was 453 (6 - 1710) days. At close-out 55 patients were alive, 103 patients had died, 25 patients were censored at the last contact date. For 2 patients no follow-up data could be received (drop-outs). All diagnostic methods significantly distinguished between operable vs. inoperable NSCLS (p < 0.05). Only in the PET/CT subgroup (UICC <= IIIA) no median survival was established. PET/CT compared to CT alone showed a significant superiority in distinguishing between operable vs. inoperable (p < 0.05), whereas PET/CT compared to PET was significant superior in the NSCLC group where PET/CT stated UICC > IIIA (inoperable) vs. PET stating UICC <= IIIA (operable) (p < 0.05). PET/CT was significantly more accurate for staging of NSCLC and a better differentiation between operable vs. inoperable NSCLC stadium was obtained.
LizenzStandard (Fassung vom 01.10.2008)
MeSHCarcinoma, non-small-cell lung