Greater reductions in blood flow after anti-angiogenic treatment in non-small cell lung cancer patients are associated with shorter progression-free survival

概要

〔目　的(Purpose)〕
　To evaluate tumor blood flow using 150-water positron emission tomography (PET) in patients with non-small cell lung cancer (NSCLC) before and after chemotherapy with bevacizumab, and to investigate the effects of bevacizumab on tumor blood flow changes and progression-free survival (PFS).

〔方法ならびに成績(Methods/Results)〕
　Twelve patients with NSCLC were enrolled. Six patients underwent chemotherapy with bevacizumab and the other six without bevacizumab. 150-water dynamic PET scans were performed within 1 week before the start of chemotherapy and within 1 week after the first day of chemotherapy. Tumor blood flow was analyzed quantitatively using a single one-tissue compartment model with the correction of pulmonary circulation blood volume and arterial blood volume via an image-derived input function. In the bevacizumab group, mean tumor blood flow was statistically significantly reduced post-chemotherapy (pre-chemotherapy 0. 27 士 0.14 mL/cm3/min, post-chemotherapy 0.18 士 0.12 ml/cm3/min). In the no bevacizumab group, there was no significant difference between mean tumor perfusion pre-chemotherapy (0. 42 ± 0. 42 mL/cm3/min) and post-chemotherapy (0. 40 ± 0.27 mL/cm3/min). In the bevacizumab group, there was a positive correlation between the blood flow ratio (tumor blood flow post-chemotherapy/tumor blood flow pre-chemotherapy) and PFS (correlation coefficient 0. 94). Mean tumor blood flow decreases after bevacizumab administration and was positively correlated with longer PFS.

〔総　括(Conclusion)〕
　Mean tumor blood flow diminished within 1-2 days after bevacizumab administration in NSCLC patients, and greater reductions in blood flow were associated with shorter PFS.