| Objective: The aim of this meta-analysis was to evaluate the prognostic value of PET/CT for survival of Extranodal NK/T cell lymphoma(NK/T).Methods: Our study search the results of PET/CT evaluation of Extranodal NK-/T-cell lymphoma prognosis in PUBMED,COCHRANE,EMBASE,CNKI,VIP?Wan Fang?CBM as of January 2019.Quality assessment was conducted for all of including studies.The data of hazard ratios(HRs)with 95% confidence interval(95% CI)was extracted from each study.Statistical analysis was performed with Stata Version 12.0 for meta-analysis.The relationship between PET/CT parameters and prognosis was evaluated by combined HR(risk ratio)before,during and after treatment,including SUVmax(maximum standard uptake value),MTV(total tumor metabolic volume),TLG(total glycolysis volume),IHP(International Harmonization Project),DS-5(Deauville standard).I2(heterogeneity)was analyzed among the results of the study.I2(> 50%)was analyzed by random effect model and I2(< 50%)was analyzed by fixed effect model.The evaluation indicators included HR(risk ratio)for PFS(progression-free survival)and OS(overall survival).Begg's and Egger's tests were used to evaluate the publication bias of the study,and sensitivity analysis was carried out.Result: Fourteen prospective or retrospective studies were included,including 707 Chinese and Korean patients with NK/T-cell lymphoma.Meta analysis results showed:1.Before treatment,the results demonstrate PFS are poor for patients in PET/CT high SUVmax group,high MTV group,high MTV group,high TLG group compared with patients in low SUVmax group(HR = 2.36,95% CI:1.04-5.36,P = 0.041),low MTV group(HR = 3.61,95% CI: 1.96-6.65,P <0.001),low TLG group,(HR = 5.63,95% CI: 95% CI: 1.93-1.93-16.44,P =0.002),patients in PET/CT high MTV group,high MTV group,high TLG group are worse than patients in low MTV group(HR=3.19,95%CI : 1.55-6.59,p=0.002),low TLG group(HR=7.78,95%CI:1.77-34.19,p=0.007),but no significant difference is found in OS between high SUVmax group and low SUVmax(HR=2.40,95% CI: 0.87-6.60,p=0.091),The HR values of PFS and OS in the high TLG group were higher than those in the high MTV group.Sensitivity analysis results: The HR results of the PSF and OS prognosis were unstable in the high SUVmax group.2.There are no significant differences in PFS(HR: 2.07,95% CI:0.427-10.03,p=0.366)and OS(HR =3.32,95% CI: 0.69-15.98,p=0.135)between patients in the during-treatment PET/CT high DS-5 score group and those in the low DS-5 score group,there is no significant difference in PFS(HR=0.39,95% CI: 0.12-1.22,p = 0.104)and OS(HR = 1.12,95% CI: 0.17-7.45,p = 0.90)between PET/CT positive patients and negative patients used by IHP in the during-treatment.Sensitivity analysis results: The high-DS-5 score group had unstable HR results for PFS and OS.3.Patients in the PET/CT high DS-5 score have poor PFS(HR=3.66,95%CI: 2.13-6.26,p<0.001)and 0S(HR=3.32,95% CI: 1.79-6.15,p<0.001)comparing with lower DS-5 score after treatment,PFS(HR=2.59,95% CI:1.21-5.54,p=0.015)and OS(HR=2.34,95 %CI: 1.14-4.80,p = 0.020)in patients with PET/CT positive IHP are worse than those in negative patients after treatment.The HR values of PFS and OS in the high DS-5 group were greater than those in the PET/CT positive group under IHP.Conclusion:1.PET / CT can be used for prognosis of patients with NK / T cell lymphoma.2.the application of MTV and TLG interpretation of pre-treatment PET /CT,DS-5 score interpretation of the end of PET / CT,can predict PFS,OS in patients with NK / T cell lymphoma. |
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