We tested the prognostic relevance of metabolic parameters and their relative changes in patients with metastatic colorectal cancer (mCRC) treated with monoclonal antibody and chemotherapy. SUV_max (standardized uptake volume), SAM (standardized added metabolic activity) and TLG (total lesion glycolysis) are assessed with ¹⁸F-fluorodeoxyglucosepositron emission tomography and computed tomography (FDG-PET/CT) to evaluate total metabolic activity of malignant processes. Our purpose was to investigate the change of glucose metabolism in relation to PFS (progression free survival) and OS (overall survival). Fifty-three patients with mCRC with at least one measurable liver metastasis were included in this prospective, multi-center, early exploratory study. All patients were treated with first-line chemotherapy and targeted therapy. Metabolic parameters, like SUV_max, SAM, normalized SAM (NSAM) and TLG were assessed by FDG-PET/CT, carried out at baseline (scan-1) and after two therapeutic cycle (scan-2). Our results suggested neither SUVmax nor TLG have such prognostic value as NSAM in liver metastases of colorectal cancer. The parameters after the two cycles of chemotherapy proved to be better predictors of the clinical outcome. NSAM after two cycles of treatment has a statistically significant predictive value on OS, while SAM was predictive to the PFS. The follow up normalized SAM after 2 cycles of first line oncotherapy was demonstrated to be useful as prognostic biomarkers for OS in metastatic colorectal cancer. We should introduce this measurement in metastatic colorectal cancer if there is at least one metastasis in the liver.

我们测试了接受单克隆抗体和化疗治疗的转移性结直肠癌 (mCRC) 患者代谢参数及其相对变化的预后相关性。^使用18 F-氟脱氧葡萄糖正电子发射断层扫描和计算机断层扫描 (FDG-PET/CT ) 评估SUV _max （标准化摄取量）、SAM（标准化附加代谢活性）和 TLG（总病变糖酵解），以评估恶性过程的总代谢活性。我们的目的是研究葡萄糖代谢的变化与 PFS（无进展生存期）和 OS（总生存期）的关系。这项前瞻性、多中心、早期探索性研究纳入了 53 名患有至少一处可测量肝转移的 mCRC 患者。所有患者均接受一线化疗和靶向治疗。通过 FDG-PET/CT 评估代谢参数，如 SUV _max、SAM、标准化 SAM (NSAM) 和 TLG，在基线（扫描 1）和两个治疗周期后（扫描 2）进行。我们的结果表明，SUVmax 和 TLG 在结直肠癌肝转移中都没有 NSAM 那样的预后价值。两个周期化疗后的参数被证明可以更好地预测临床结果。两个治疗周期后的 NSAM 对 OS 具有统计学显着的预测价值，而 SAM 对 PFS 具有预测价值。一线肿瘤治疗 2 个周期后的随访标准化 SAM 被证明可作为转移性结直肠癌 OS 的预后生物标志物。如果肝脏中至少有一个转移，我们应该在转移性结直肠癌中引入这种测量。