局部晚期鼻咽癌放疗前后氟脱氧葡萄糖PET—CT摄取值与预后关系的研究  

Prognostic value of fluorodeoxyglucose positron emission tomography-computed tomography before and after radiotherapy in locally advanced nasopharyngeal carcinoma

作　　者：谢鹏[1] 岳金波[1] 孙新东[1] 冯瑞[1] 孔莉[1] 付政[2] 郑劲松[2] 赵献光[1] 于金明[1] 

机构地区：[1]山东省肿瘤医院放疗科,济南250117 [2]山东省肿瘤医院核医学科,济南250117

出　　处：《中华放射肿瘤学杂志》2009年第5期347-350,共4页Chinese Journal of Radiation Oncology

摘　　要：目的研究局部晚期鼻咽癌患者放疗前后氟脱氧葡萄糖（FDG）PET-CT最大标准摄取值（SUVmax）动态变化与预后的关系。方法回顾性分析我院2002-2004年放疗前后行FDGPET-CT检查且资料完整的58例经病理证实的Ⅲ～Ⅳ。期鼻咽癌患者，所有患者均采用6MVX线调强放疗联合顺铂＋氟尿嘧啶方案化疗。随访5年并分析放疗前后原发灶和颈部淋巴结转移灶SUVmax与预后的关系。结果全组患者5年总生存率（OS）为62％，5年无瘤生存率（DFS）为53％。放疗前原发灶SUVmax〈8．0者5年OS和DFS均比SUVmax≥8．0者高[80％：49％（X^2=5．36，P=0．021）和68％：42％（x^2=4．23，P=0．040）]；放疗后代谢完全缓解者5年OS和DFS均比代谢部分缓解者高[74％：46％（x^2=5．12，P=0．024）和65％：38％（x^2=5．54，P=0．019）]。淋巴结转移灶SUVmax值高于原发灶SUVmax者预后较差（x^2=4．06，P=0．044）。结论放疗前后FDGPET—CTSUVmax与局部晚期鼻咽癌患者预后密切相关，其中SUVmax较高者及淋巴结转移灶SUVmax值高于原发灶SUVmax者预后较差。Objective To evaluate the prognostic value of maximal standard uptake values （SUVmax） of fluorodeoxyglucose positron emission tomography-computed tomography （FDG PET-CT） in patients with locally advanced nasopharyngeal carcinoma （NPC）. Methods From October 2002 to January 2004, 58 patients with locally advanced NPC who had undergone FDG PET-CT scan before and after radio- therapy were reviewed retrospectively. FDG uptake of primary tumors and neck nodes represented by SUVmax was measured. All patients received intensity-modulated radiotherapy using 6 MV X-rays combined with platinum-based chemotherapy. The relation between the change of the SUVmax before and after radiotherapy and treatment outcomes was analyzed. Results The median follow-up was 61 （9 - 69） months. The 5-year overall survival （OS） and disease-free survival （DFS） were 62% and 53%. The patients with tumor SUVm= 〈 8.0 before radiation had a significantly better 5-year OS （ 80% vs. 49% , X^2 = 5.36, P = 0.021 ） and DFS （68% vs. 42%, X^2 = 4.23,P = 0.040） than those with tumor SUVmax ≥ 8. 0. The patients who achieved a metabolic complete response （MCR） had significantly higher 5-year OS （74% vs. 46% , X^2 = 5.12,P = 0.024） and DFS （65% vs. 38% , x^2 = 5.54,P = 0.019 ） than those who only achieved metabolic partial response （MPR）. Poor prognosis was found in patients with the neck lymph node SUVmax higher than that of the primary tumor before radiotherapy （ SUVmax 〉 SUVmax P ） （ x^2 = 4. 06, P = 0. 044）. Conclusions The SUVmax before radiotherapy and metabolic response to radiotherapy may predict the prognosis of paitents with locally advanced NPC. The prognosis is poor for patients with high FDG uptake before and after radiotherapy or SUVmax 〉 SUVmax P.

关 键 词：鼻咽肿瘤/放射疗法 断层摄影术 正电子发射型 氟脱氧葡萄糖 预后 

分 类 号：R686[医药卫生—骨科学]