^(18)F-FDG PET/CT对非小细胞肺癌治疗策略的影响  

Impact of ^(18)F-FDG PET/CT on treatment strategy of non-small cell lung cancer

作　　者：珊丹[1] 韩波[1] 于丽娟[2] 王瑞芝[3] 潘慧莹[1] 

机构地区：[1]哈尔滨医科大学附属第一医院肿瘤放射治疗科,黑龙江哈尔滨150001 [2]哈尔滨医科大学附属肿瘤医院PET-CT中心,黑龙江哈尔滨150008 [3]哈尔滨医科大学附属肿瘤医院肿瘤放射治疗科,黑龙江哈尔滨150008

出　　处：《中国医学影像技术》2009年第12期2271-2274,共4页Chinese Journal of Medical Imaging Technology

基　　金：黑龙江省教育厅科学技术研究项目(11521175)

摘　　要：目的探讨18F-FDG PET/CT扫描对非小细胞肺癌(NSCLC)治疗策略的影响及临床意义。方法对拟行根治性放疗或手术的60例经病理确诊的NSCLC患者进行PET/CT检查。将入组患者根据其CT表现分为A(Ⅰ~Ⅱ期)、B(Ⅲ期)2组,各30例,再根据PET/CT扫描结果重新分期,并比较两种分期结果及相应的治疗策略的变化。结果①PET/CT改变临床分期:PET/CT扫描使53.33%(32/60)的患者临床分期发生改变,包括3例的T分期、23例的N分期和9例的M分期发生改变;其中腺癌分期改变者65.85%(27/41),鳞癌分期改变者26.32%(5/19,P<0.05);中心型肺癌分期改变者34.29%(12/35),边缘型肺癌分期改变者57.14%(20/35,P<0.05)。②PET/CT改变治疗策略:全组9例患者因发现远处转移而从根治改为姑息治疗;拟行手术治疗的25例,其中32.00%(8/25)改行根治性放疗,20.00%(5/25)改行姑息治疗;拟行根治放疗的35例中,因分期升高11.43%(4/35)改为姑息放疗;因分期降低,5.71%(2/35)改为根治性手术。结论PET/CT扫描对NSCLC的临床分期有显著影响,并能改变治疗策略。Objective To evaluate the impact of PET/CT on the clinical therapeutical strategy of patients with non-small cell lung cancer（NSCLC）.Methods Sixty patients with histologically confirmed NSCLC supposed to accept radical radiotherapy or surgical operation were firsthy divided into group A（stage Ⅰ—Ⅱ） and group B（stage Ⅲ） according to CT findings,and the individualized treatment strategy was designed,then restage and compare with different stage and management with initial treatment strategy by PET/CT scanning.Results ①PET/CT scanning restaged the TNM stage in 53.33%（32/60） patients,including 3 of T stage,23 of N stage and 9 of M stage.Changes of stage occurred in 65.85%（27/41） patients with adenocarcinoma and in 26.32%（5/19） with squamous carcinoma（P〈0.05）,while in 34.29（12/35） with central and 57.14%（20/35） with peripheral NSCLCs（P〈0.05）.②PET/CT scanning resulted in alteration of the managements of NSCLC patients.The management changed from radical into palliative strategy with PET/CT information in 9（15.00%） patients.In 25 patients who were supposed to accept surgical operation,the treatment changed to radical radiotherapy in 8（8/25,32.00%） and to palliative radiotherapy in 5（20.00%） patients.In 35 patients who were supposed to accept radiotherapy,surgical operation or palliative radiotherapy was finally chosen in 5.71%（2/35） and 11.43%（4/35） patients,respectively.Conclusion PET/CT images can make significant alteration to clinical stage and treatment plan in patients with NSCLC.

关 键 词：肺肿瘤 18F氟脱氧葡萄糖 体层摄影术 发射型计算机 

分 类 号：R734.2[医药卫生—肿瘤] R817.4[医药卫生—临床医学]