MD-OncoMD-OncoMD-Onco2782-32022782-6171Publishing House ABV Press16610.17650/2782-3202-2024-4-4-119-128DIAGNOSTIC CAPABILITIESВОЗМОЖНОСТИ ДИАГНОСТИКИThe prognostic value of the tumor metabolic volume in predicting the response to therapy in patients with diffuse large B-cell lymphomaПрогностическая ценность общего метаболического объема опухоли в прогнозировании ответа на терапию у больных диффузной В-крупноклеточной лимфомойhttps://orcid.org/0009-0009-6911-3322VovchenkoA. A.ВовченкоА. А.
Russian Federation

Artem Andreevich Vovchenko

4 Koroleva St., Obninsk, 249031

1 Studgorodok Territory, Obninsk, 249039

Артем Андреевич Вовченко

249036, Обнинск, ул. Королева, 4

249039, Обнинск, тер. Студгородок, 1

dr.vovchenkoartem@gmail.comhttps://orcid.org/0009-0009-0188-8420GalitsynaA. B.ГалицынаА. Б.
Russian Federation

4 Koroleva St., Obninsk, 249031

1 Studgorodok Territory, Obninsk, 249039

249036, Обнинск, ул. Королева, 4

249039, Обнинск, тер. Студгородок, 1

https://orcid.org/0000-0002-0023-4216FalaleevаN. A.ФалалееваН. А.
Russian Federation

4 Koroleva St., Obninsk, 249031

1 Studgorodok Territory, Obninsk, 249039

249036, Обнинск, ул. Королева, 4

249039, Обнинск, тер. Студгородок, 1

KhodzhibekovaM. M.ХоджибековаМ. М.
Russian Federation

3 2ndBotkinskiy Proezd, Moscow, 125284

125284, Москва, 2-й Боткинский проезд, 3

https://orcid.org/0000-0003-3536-0770ShuvaevV. A.ШуваевВ. А.
Russian Federation

4 Koroleva St., Obninsk, 249031

1 Studgorodok Territory, Obninsk, 249039

249036, Обнинск, ул. Королева, 4

249039, Обнинск, тер. Студгородок, 1

https://orcid.org/0009-0007-9269-7405ManaenkovD. A.МанаенковД. А.
Russian Federation

4 Koroleva St., Obninsk, 249031

249036, Обнинск, ул. Королева, 4

https://orcid.org/0000-0001-7689-6032IvanovS. A.ИвановС. А.
Russian Federation

4 Koroleva St., Obninsk, 249031

1 Studgorodok Territory, Obninsk, 249039

249036, Обнинск, ул. Королева, 4

249039, Обнинск, тер. Студгородок, 1

A.F. Tsyba Medical Radiological Research Center – branch of the National Medical Research Radiological Center, Ministry of Health of RussiaМедицинский радиологический научный центр им. А.Ф. Цыба – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава РоссииObninsk Institute of Atomic Energy – branch of the National Research Nuclear University “MEPhI”Обнинский институт атомной энергетики – филиал ФГАОУ ВО «Национальный исследовательский ядерный университет «МИФИ»P.A. Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre, Ministry of Health of RussiaМосковский научно-исследовательский онкологический институт им. П.А. Герцена – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава России16012025441191281601202516012025Copyright ©; 2025, ABV-PressCopyright ©; 2025, АБВ-пресс2025ABV-PressАБВ-прессhttps://mdonco.abvpress.ru/jour/about/editorialPolicieshttps://mdonco.abvpress.ru/jour/article/view/166

Background. Metabolic tumor volume (MTV) is an insufficiently studied parameter of positron emission tomography, combined with computer tomography (PET/CT), which has been gaining increasing interest in modern oncology in recent years. It is important to use MTV as a prognostic marker in diffuse large B-cell lymphoma (DLBCL).

Aim. To analyze the results of therapy in patients with DLBCL and to identify their relationship with MTV, determined by PET/CT data before the start of treatment, after 2 and 6 courses of therapy.

Materials and methods. The prospective study included 80 patients with a morphologically verified diagnosis of DLBCL who were treated at the A.F. Tsyba Medical Radiological Research Center from 2021 to 2024. All patients underwent therapy using R-CHOP regimens (66.25 %) and R-CHOP-like regimens (33.75 %). Each of the patients underwent 3 PET/CT studies with MTV registration – at the staging stage, after 2 and after 6 treatment courses. The median follow-up was 19.5 (4.97–45.53) months. The survival rate was calculated using the Kaplan–Mayer technique, the MTV threshold values were calculated using ROC analysis taking into account the Yuden index.

Results. On the initial PET/CT, the threshold value of MTV was 37.12 cm3 (p = 0.006). In patients with a value above the threshold, failures of classical first-line therapy were statistically significantly more common. The threshold value of MTV in PET/CT after 2 courses of treatment was 19.15 cm3 (p = 0.032), in PET/CT after 6 courses – 8.73 cm3 (p = 0.028). In patients with an MTV value above the threshold, according to the results of PET/CT performed after the 2nd and 6th courses, cases of disease progression were also statistically significantly more frequent.

Conclusion. MTV is a new prognostic factor in modern oncological practice and should be evaluated in all patients with DLBCL and taken into account when making decisions regarding therapy tactics.

Введение. Метаболический объем опухоли (metabolic tumor volume, MTV) – недостаточно изученный параметр позитронноэмиссионной томографии, совмещенной с компьютерной томографией (ПЭТ/КТ), вызывающий все больший интерес в современной онкологии в последние годы. Представляется важным применение MTV как прогностического маркера при диффузной В-крупноклеточной лимфоме (ДВККЛ).

Цель исследования – проанализировать результаты терапии пациентов с ДВККЛ и выявить их взаимосвязь с MTV, определяемым по данным ПЭТ/КТ до начала лечения, после 2 и 6 курсов терапии.

Материалы и методы. В проспективное исследование вошли 80 пациентов с морфологически верифицированным диагнозом ДВККЛ, которые проходили лечение в МРНЦ им. А.Ф. Цыба с 2021 по 2024 г. Все пациенты получили терапию с использованием схем R-CHOP (66,25 %) и R-CHOP-подобных режимов (33,75 %). Каждому из пациентов проводили 3 ПЭТ/КТисследования с регистрацией MTV – на этапе стадирования, после 2-го и 6-го курсов лечения. Медиана наблюдения составила 19,5 (4,97–45,53) мес. Показатели выживаемости рассчитывали с применением методики Каплана–Майера, пороговые значения MTV – с помощью ROC-анализа с учетом индекса Юдена.

Результаты. При инициальной ПЭТ/КТ пороговое значение MTV составило 37,12 см3 (р = 0,006). У пациентов со значением MTV выше порогового статистически значимо чаще наблюдались неудачи классической терапии 1-й линии. Пороговое значение MTV при ПЭТ/КТ после 2 курсов лечения составило 19,15 см3 (р = 0,032), при ПЭТ/КТ после 6 курсов – 8,73 см3 (р = 0,028). У пациентов со значением MTV выше порогового по результатам исследований, проведенных после 2 и 6 курсов, также статистически значимо более часто констатировали случаи прогрессирования заболевания.

Выводы. MTV является новым прогностическим фактором в современной онкологической практике и должен оцениваться у всех пациентов с ДВККЛ и учитываться при принятии решений, касающихся тактики терапии.

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