İmmunoterapi alan hastaların dalak hacmi, dalak/karaciğer SUVmax oranı ve değişim yüzdelerinin genel sağkalım arasındaki ilişki

Yıl 2025, Cilt: 8 Sayı: 4, 720 - 725, 30.07.2025

İhsan Kaplan , Özlem Beyler

https://doi.org/10.32322/jhsm.1689929

Öz

Amaçlar: Amacımız immunoterapi alanlarda tedavi öncesi ve tedavi sonrası dalak hacmi (SV), dalak/karaciğer SUVmax oranı (SLR) ve değişim yüzdelerinin (Δ) genel sağkalım (OS) arasındaki ilişkisini araştırmaktır.

Yöntemler: Çalışmamız retrospektif olarak Ekim 2017-Kasım 2023 tarihleri arasında immunoterapi öncesinde (bazal), tedavi sonrası 3. ay ve 6. ayında FDG PET/BT görüntülemeleri yapılan hastalar alındı. Hastaların 89’una bazal ve tedavi sonrası 3 ay, 53’ünde ise bazal, tedavi sonrası 3. ve 6. ay PET/BT görüntülemeleri yapıldı. FDG PET/BT’nin CT görüntüleri ile bazal, tedavi sonrası 3. ve 6. ayında dalak hacmi, füzyon görüntüleri dalak SUVmax, karaciğer SUVmax parametereleri ölçüldü. Hasta yaşı ve ölüm tarihleri kayıt altına alındı.

Bulgular: Çalışmamızda hastaların 52’si (%58.4) erkek ve median yaşı 62 (23-91) olarak bulundu. OS median 17.7 (4-83) ay olarak bulundu. Bazal median SV 230 mL (47-1870)’idi. Bazal SLR1 median değeri 0.80 (0.33-1.48) olarak bulundu. Bazal ve tedavi sonrası 3 aydaki ΔSV1 median -1.34 (-55.03-155.37) idi. SLR bazal ve tedavi sonrası değişim yüzdesi (ΔSLR1) median -.52 (-48.39-121.02). SLR1 cut-off değeri > 0.80 alındığında mortaliteyi tespit etmede % 64.2 sensitivite ve % 65.2 spesifiteye sahipti. Çalışma süresince 89 hastanın 63’si (% 70.8) öldüğü saptandı. SLR1 değeri için ≤ 0.79 median OS 29.5 ay olup 1-3 yıllık sağkalım % 87/37 bulundu. SLR1 ve SLR3 değerinin OS üzerine bağımsız prognostik faktör olduğu tespit edildi (sırasıyla p = 0.003 ve p = 0.004).

Sonuç: İmmunoterapi öncesi ve tedavi sonrası 3. ayında SV değerleri ile tedavi öncesi ve tedavi sonrası 6. ay sonraki SLR değerleri OS üzerine prognostik faktörler olduğunu tespit ettik. Tedavi öncesi ve tedavi sonra 6.ayda FDG PET/BT’den elde edilen SLR1 değeri için > 0.79 ve SLR3 değeri için > 0.80 olanlar daha kısa OS sahiptiler ve OS için bağımsız prognostik faktörler olduğunu bulduk.

Anahtar Kelimeler

FDG PET/BT , İmmünoterapi , Dalak Hacmi , Dalak/Karaciğer SUVmax oranı , Genel Sağkalım

Relationship between spleen volume, spleen/liver SUVmax ratio, and percentage change and overall survival in patients undergoing immunotherapy

Öz

Aims: This study aimed to investigate the pre- and post-treatment associations between spleen volume (SV), spleen/liver maximum standardized uptake value (SUVmax) ratio (SLR), and percent change (Δ) and overall survival (OS) in patients undergoing immunotherapy.
Methods: This retrospective study included 89 patients who underwent 18F FDG PET/CT imaging before immunotherapy (baseline) and during post-treatment at 3 and 6 months. SV, spleen SUVmax, and liver SUVmax parameters were determined based on PET/CT images. Patients’ ages and date of mortality were recorded.
Results: In the present study, 52 (58.4%) were men, and the median OS was 17.7 (4-83) months. Furthermore, 63 out of 89 patients (70.8%) died during the study period. Baseline median SV value was 230 ml (47-1870). Baseline median SLR value was 0.80 (0.33-1.48). Median ΔSV1 at baseline and at 3 months post-treatment was -1.34 (-55.03-155.37). Percent change in SLR baseline and post-treatment (ΔSLR1) median was -0.52 (-48.39-121.02). Moreover, SLR1 had a sensitivity of 64.2% and specificity of 65.2% in detecting mortality with a cutoff value of >0.80. For a SLR1 value of ≤0.79, median OS was 29.5 months and 1-3-year survival was 87/37%. SLR1 and SLR3 were independent prognostic factors for OS (p=0.003 and p=0.004, respectively).
Conclusion: SV values before and at 3 months post-immunotherapy and SLR values before and at 6 months post-treatment were prognostic factors for OS. Higher SLR1 and SLR3 values from 18F FDG PET/CT before and at 6 months post-treatment were independent prognostic factors and associated with shorter OS.

Anahtar Kelimeler

FDG PET/CT , immunotherapy , spleen volume , spleen/liver SUVmax ratio , overall survival

Kaynakça

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