^99Tc^m-HL91显像预测鼻咽癌放疗敏感性的初步研究  

Preliminary study on the value of ^99Tc^m-HL91 imaging in predicting sensitivity to radiotherapy in patients with nasopharyngeal cardnoma

作　　者：刘生[1] 薛咏[1] 张弘[1] 梁九根[1] 卢献平[1] 刘幸光[1] 陈少雄[1] 蒋宁一[1] 

机构地区：[1]中山大学附属第二医院核医学科,广州 510120

出　　处：《中华肿瘤杂志》2007年第5期369-372,共4页Chinese Journal of Oncology

摘　　要：目的探讨^99Tc^m-HL91显像预测鼻咽癌（NPC）放疗敏感性和预后的关系。方法34例临床确诊的Ⅱ～Ⅳa期初发鼻咽癌患者于放疗前1周进行^99Tc^m-HL91显像,其中18例放疗前行辅助化疗。半定量分析鼻咽部原发灶及颈淋巴结转移的乏氧情况,并与放疗中期（放疗剂量一半）、放疗后4个月和1年的临床情况比较。结果（1）初步辅助化疗患者的总体疗效与鼻咽癌原发灶的乏氧程度无显著相关性,与T／Mu和T／Ce的相关系数分别为-0．394和-0．510（P=0．145和P= 0．052）。但化疗显效组与好转组的T／Mu和T／Ce值差异有统计学意义。（2）放疗中期,鼻咽癌原发灶退缩程度与乏氧显像T／Mu和T／Ce值存在负相关（相关系数分别为-0．602和-0．643,P值均〈 0．01）。（3）放疗后4个月随访的24例患者,1例出现肺、骨转移,其余患者病灶均得到控制。放疗后1年,8例患者中,6例病灶完全消失或未进展,T／Mu为1．30±0．23,T/Ce为3．61±0．84;2例复发（Ⅲ、Ⅳa期）患者中,T／Mu分别为1．40和1．27,T／Ce分别为4．10和3．85。复发组与未复发组比较,差异无统计学意义。（4）放疗中期颈淋巴结退缩程度与乏氧程度无明显的相关性。结论^99Tc^m- HL91乏氧显像能预测鼻咽癌患者对放疗的敏感性,有助于实行个体化治疗;能否预测远期疗效有待进一步的研究。Objective To investigate the feasibility of ^99Tc^m-HL91 imaging in prediction of radiotherapy sensitivity of naqsopharyngeal cancer （NPC） and its relationship with prognosis. Methods 34 patients with NPC confirmed by pathology, staging from Ⅱ - Ⅳa , underwent ^99Tc^m-HL91 SPECT imaging one week before radiotherapy. 18 of them received adjuvant chemotherapy. The hypoxia in primary nasopharyngeal lesions and cervical lymph node metastases were calculated semi-quantitatively, and compared with clinical findings in medium-term therapy at 4 months and 1 year post therapy. Results （ 1 ） There was no significant relationship between the total preliminary curative effect of adjuvant chemotherapy and the degree of nasopharyngeal lesion hypoxia （ T/Mu, γ= - 0. 394, P = 0. 145 ; T/Ceγ = - 0.510, P = 0. 052 ）. But there was a significant difference between the partial curative effect group and significant curative effect group. （2） The degree of NPC regression in the medium-term radiotherapy group was negatively correlated with the degree of hypoxia （ T/Mu, γ= - 0. 602 ; T/Ce, γ= - 0.643, P 〈 0.01 ）. （3） 23 patients had good local control except one case with lung and bone metastasis 4 months post-therapy. The lesions disappeared or not developed in 6 patients（T/Mu 1.30±0. 23, T/Ce 3.61±0. 84）. Two patients at stage Ⅲ and Ⅳa relapsed （T/Mu were 1. 40 and 1. 27, respectively; T/Ce were 4. 10 and 3. 85, respectively）, there was no significant difference. （4）The degree of lymph node hypoxia had no correlation with the curative effect on medium-term radiotherapy. Conclusion ^99Tc^m-HL91 hypoxia imaging may predict sensitivity to radiotherapy in patients with NPC, with a potential help to carry out individual therapy. However, further investigation is needed to ascertain whether it could predict the long-time curative effect on NPC radiotherapy.

关 键 词：鼻咽肿瘤 放疗敏感性 肿瘤乏氧 ^99TC^M-HL91 

分 类 号：R686[医药卫生—骨科学]