Radiation Oncology Journal

  • 제23권1호
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  • Pages.9-16
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  • 2005
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  • 2234-1900(pISSN)
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  • 2234-3156(eISSN)
대한방사선종양학회 (The Korean Society for Radiation Oncology)
권호 표지

비인강암 환자의 예후에서 $2-[18^F]$ Fluoro-2-Deoxy-D-Glucose PET 영상에서 계산되는 Standardized Uptake Value의 의의

Prediction of Prognosis to Concurrent Chemo-Radiotherapy by Standardized Uptake Value of $2-[18^F]$ Fluovo-2-Deoxy-D-Glucose for Nasopharyngeal Carcinomas

  • 이상욱 (울산대학교 의과대학 서울아산병원 방사선종양학과) ;
  • 임기천 (울산대학교 의과대학 서울아산병원 핵의학과) ;
  • 남순열 (울산대학교 의과대학 서울아산병원 핵의학과) ;
  • 김재승 (울산대학교 의과대학 서울아산병원 핵의학과) ;
  • 최은경 (울산대학교 의과대학 서울아산병원 방사선종양학과) ;
  • 안승도 (울산대학교 의과대학 서울아산병원 방사선종양학과) ;
  • 신성수 (울산대학교 의과대학 서울아산병원 방사선종양학과) ;
  • 류진숙 (울산대학교 의과대학 서울아산병원 핵의학과) ;
  • 김상윤 (울산대학교 의과대학 서울아산병원 이비인후과) ;
  • 이봉재 (울산대학교 의과대학 서울아산병원 이비인후과) ;
  • 최승호 (울산대학교 의과대학 서울아산병원 이비인후과) ;
  • 김성배 (울산대학교 의과대학 서울아산병원 종양학과) ;
  • 문대혁 (울산대학교 의과대학 서울아산병원 핵의학과)
  • Lee Sang-wook (Department of Radiation Oncology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Im Ki Chun (Department of Nuclear Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Nam Soon Yuhl (Department of Otorhinolaryngology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Kim Jae Seung (Department of Nuclear Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Choi Eun Kyung (Department of Radiation Oncology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Ahn Seung Do (Department of Radiation Oncology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Shin Seong Soo (Department of Radiation Oncology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Ryu Jin Sook (Department of Nuclear Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Kim Sang Yoon (Department of Otorhinolaryngology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Lee Bong-Jae (Department of Otorhinolaryngology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Choi Seung-Ho (Department of Otorhinolaryngology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Kim Sung-Bae (Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Moon Dae Hyuk (Department of Nuclear Medicine, University of Ulsan College of Medicine, Asan Medical Center)
  • 발행 : 2005.03.01
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초록

목적 : 원격존기의 전이가 없는 비인강암에서 동시항암화학방사선치료를 시행 받은 환자에서 진단 당시 시행한 양전자단층촬영의 fluorodeoxyglucose (FDG) 섭취정도가 예후에 미치는 영향을 알아보고자 하였다. 대상 및 방법 : 본원에서 원격장기의 전이가 없는 비인강암으로 진단 받고 진단 당시 ($[18^F]$FDG-PET을 시행한 환자는 총 41명이었다. PET 검사는 모두 항암방사선치료 전에 시행되었다. FOG 섭취 정도를 알아보기 위해서 종양 내에서 측정된 최대 standardized uptake value (SUV)를 측정하였다. 결과 : 항암화학방사선지료 후 모든 환자는 완전반응을 보였다. 전체 41명 중에서 10명이 재발하였는데 재발하지 않은 환자의 $SUV_{max}$ 중앙값은 6.48 (range: $2.31\~26.07$)이었고 재발한 환자의 중앙 $SUV_{max}$는 $8.55(2.49\~14.81)$이었다. 양 군 간의 5UV의 차이는 p값이 0.0505로 통계적 차이가 관찰되지 않았다. $SUV_{max}$를 중앙값을 기준으로 나누어 보았을 때 $SUV_{max}$가 높은 환자의 3년 생존율이 통계적으로 유의하게 저조하였다($51\%\;{\nu}91\%$, p=0.0070). 결론 : 원격전이가 없는 비인강암에서 항암화학방사선치료를 시행 받은 환자에서 진단 당시 시행한 FDG 섭취 정도는 예후를 예측하는데 유용할 것으로 생각되었다. 따라서 진단 당시 시행한 FDG-PET에서 SUV가 높은 경우(8 이상)에는 좀더 적극적인 치료가 필요할 것으로 생각하였다.

Purpose : To prospectively evaluate the use of positron emission tomography with the glucose analog fluoro-deoxyglucose (FDG-PET) to deoxyglucose (FDG-PET) to predict disease-free survival (DFS) after concurrent chemo-radiotherapy (CCRT) in patients with non-disseminated nasopharyngeal carcinoma (NPC). Materials and Methods : We studied 41 patients with non-disseminated NPC scheduled to undergo platinum-based CCRT were eligible for this study. Patients were studied by FDG-PET prior to the CCRT. FDG uptake of tumors were measured with the maximal standardized uptake value (SUV). Results : Complete response rate was $100\%$. In ten patients who presented with any component of treatment failure, the median $SUV_{max}$ was 8.55 (range: $2.49\~14.81$) in any component of failure and the median $SUV_{max}$ was 5.48 (range: $2.31\~26.07$) In the remaining patients without any such failure. Patients having tumors with high FDG uptake had a significantly lower 3-year DFS ($51\%\;{\nu}91\%$, p=0.0070) compared with patients having low uptake tumors. Conclusion : FDG uptake, as measured by the SUV, has potential value in predicting DFS in NPC treated by CCRT, High FDG uptake may be a useful parameter for Identifying patients requiring more aggressive treatment approaches.

키워드

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