The role of baseline F-FDG PET/CT for survival prognosis in NSCLC patients undergoing immunotherapy: a systematic review and meta-analysis

Autor: Mingxing Huang, Yuheng Zou, Weichen Wang, Qianrui Li, Rong Tian
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Therapeutic Advances in Medical Oncology, Vol 16 (2024)
Druh dokumentu: article
ISSN: 1758-8359
17588359
DOI: 10.1177/17588359241293364
Popis: Background: The value of pretreatment baseline 18 F-fluorodeoxyglucose positron emission tomography ( 18 F-FDG PET)/computed tomography (CT) as a prognostic factor for survival of patients with non-small-cell lung cancer (NSCLC) receiving immunotherapy remained uncertain. Objectives: To investigate the prognostic ability of baseline 18 F-FDG PET/CT in patients with NSCLC receiving immunotherapy. Design: A systematic review and meta-analysis. Data sources and methods: We searched the PubMed, EMBASE, and Cochrane Central Register of Controlled Trials databases until May 7, 2024, and extracted data related to patient characteristics, semiquantitative parameters of 18 F-FDG PET/CT, and survival. We pooled hazard ratios (HRs) to evaluate the prognostic value of the maximum standardized uptake value (SUV max ), mean standardized uptake value (SUV mean ), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) for overall survival (OS) and progression-free survival (PFS). Results: A total of 22 studies (1363 patients, average age range 30–88 years) were included. Baseline 18 F-FDG PET/CT-derived MTV was significantly associated with both OS (HR: 1.124, 95% confidence interval (CI) 1.058–1.195, I 2 = 81.70%) and PFS (HR: 1.069, 95% CI: 1.016–1.124, I 2 = 71.80%). Other baseline 18 F-FDG PET/CT-derived parameters, including SUV max (OS: HR: 0.930, 95% CI: 0.718–1.230; PFS: HR: 0.979, 95% CI: 0.759–1.262), SUV mean (OS: HR: 0.801, 95% CI: 0.549–1.170; PFS: HR: 0.688, 95% CI: 0.464–1.020), and TLG (OS: HR: 0.999, 95% CI: 0.980–1.018; PFS: HR: 0.995, 95% CI: 0.980–1.010), were not associated with survival. Sensitivity analyses by removing one study at a time did not significantly alter the association between MTV and PFS or between MTV and OS. There was no evidence of publication bias. Conclusion: Pretreatment baseline 18 F-FDG PET/CT-derived MTV might be a prognostic biomarker in NSCLC patients receiving immunotherapy. Further studies are needed to support routine use.
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