進行子宮頸癌術前動注化学療法の効果判定における新たな画像診断法・FDG-PETの有用性

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Neoadjuvant chemotherapy (NAC) is widely used to reduce the tumor bulk in patients with advanced uterine cervical squamous cell cancer. We examined the tumors in 2 patients before and after NAC by fluoro-deoxy-D-glucose-positron emission tomography (FDG-PET) as well as by MRI. Measurement of a tumor marker (SCC) was also done., in order to examine the clinical significance of FDG-PET. 36-year-old-woman (case 1), cervic cancer stage IIb complicated with adenomyosis. She received 2 courses of NAC (NDP:100mg, BLM: 25mg, MMC:10mg). After this therapy, MRI showed that the tumor had almost disappeared. The SCC level returned to normal, decreasing from 2.3ng/ml to 0.5ng/ml, but FDG-PET still showed activity in the tumor: the standardized uptake value was reduced from 9.49 to 4.35, but was still above the normal range (<3.0). 47-year-old-woman (case2), cervical cancer stage fib. She received 2 courses of NAC. MRI showed reduction of the tumor by 76% and the SCC level declined markedly from 120ng/ml to 3.7ng/ml, but FDG-PET still showed strong tumor activity the standardized uptake value was reduced from 14.57 to 9.76, but still greatly exceeded the normal range. Pathologic examination of tissue removed at operation demonstrated that strong tumor activity still remained in both cases. These results indicate that FDG-PET may be more useful for assessing therapeutic efficiency than conventional techniques.
社団法人日本産科婦人科学会の論文
2002-03-01

進行子宮頸癌術前動注化学療法の効果判定における新たな画像診断法・FDG-PETの有用性

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