探索基线和早期 18F-FDG PET/CT 评估在预测接受细胞周期蛋白依赖性激酶抑制剂联合内分泌治疗的 ER/HER2-转移性乳腺癌患者 PFS 中的价值。 66 名连续接受过内分泌治疗的乳腺癌患者回顾性纳入治疗前 18F-FDG PET/CT 和治疗前 6 个月内的第二次 PET/CT。计算代谢肿瘤体积（MTV）和总病灶糖酵解（TLG）和Dmax（代表肿瘤扩散并定义为两个最远病灶之间的距离）。这些参数在基线和早期评估 PET 之间的变化以及使用 PERCIST 的治疗评估被评估为 18 个月时 PFS 的预测因素。中位随访时间等于 22.5 个月。发生了 30 次进展 (45.4%)。平均事件发生时间为 17.8±10.4 个月。在基线时，Dmax 是唯一的预测代谢参数。基线 Dmax ≤ 18.10 cm 的患者的 18 m-PFS 生存率明显优于其他患者：69.2% (7.7%) 对比 36.7% (8.8%)，p = 0.017。 PERCIST 评估与 18 m-PFS 状态之间没有关联 (p = 0.149)，并且分类为完全、部分代谢缓解者或患有稳定代谢疾病的患者之间的 18 m-PFS 状态没有差异。基线 PET 时的疾病传播，根据 Dmax 评估，可预测 18 个月内发生的事件。在没有早期代谢进展的情况下（15% 的患者会出现这种情况），无论初始治疗反应的质量如何，都应继续治疗。© 2024。作者。

Exploring the value of baseline and early 18F-FDG PET/CT evaluations in prediction PFS in ER+/HER2- metastatic breast cancer patients treated with a cyclin-dependent kinase inhibitor in combination with an endocrine therapy.Sixty-six consecutive breast cancer patients who underwent a pre-therapeutic 18F-FDG PET/CT and a second PET/CT within the first 6 months of treatment were retrospectively included. Metabolic tumour volume (MTV) and total lesion glycolysis (TLG) and Dmax, which represents tumour dissemination and is defined as the distance between the two most distant lesions, were computed. The variation in these parameters between baseline and early evaluation PET as well as therapeutic evaluation using PERCIST were assessed as prognosticators of PFS at 18 months.The median follow-up was equal to 22.5 months. Thirty progressions occurred (45.4%). The average time to event was 17.8 ± 10.4 months. At baseline, Dmax was the only predictive metabolic parameter. Patients with a baseline Dmax ≤ 18.10 cm had a significantly better 18 m-PFS survival than the others: 69.2% (7.7%) versus 36.7% (8.8%), p = 0.017. There was no association between PERCIST evaluation and 18 m-PFS status (p = 0.149) and there was no difference in 18 m-PFS status between patients classified as complete, partial metabolic responders or having stable metabolic disease.Disease spread at baseline PET, as assessed by Dmax, is predictive of an event occurring within 18 months. In the absence of early metabolic progression, which occurs in 15% of patients, treatment should be continued regardless of the quality of the initial response to treatment.© 2024. The Author(s).