中晚期前列腺癌PET/CT定位三维适形放疗的疗效和预后分析  

Therapeutic Effect and Prognosis Analysis of ^(18)FDG PET/CT Positioning Three-dimensional Conformal Radiotherapy for Advanced Prostate Carcinoma

作　　者：任宝志[1] 周玉霞[1] 钟立松[1] 袁建军[1] 张仟仕[1] 陶星[2] 

机构地区：[1]德阳市人民医院肿瘤科,四川德阳618000 [2]上海交通大学医学院苏州九龙医院核医学科PET/CT室,江苏苏州215021

出　　处：《肿瘤预防与治疗》2012年第1期27-30,共4页Journal of Cancer Control And Treatment

摘　　要：目的:探讨中晚期前列腺癌经^(18)FDG PET/CT定位适形放疗的疗效、副反应及失败原因。方法:对68例中晚期前列腺癌患者随机分为^(18)FDG PET/CT定位适形放疗组(PET/CT组)和普通CT定位适形放疗组(普通CT组)。PET/CT组用PET/CT扫描定位,将扫描数据输入三维治疗计划系统,将PET图像和CT图像融合后进行靶区(GTV与PTV)和重要脏器勾画、三维重建,制定计划后常规分割适形放疗40Gy左右,然后缩野放疗至总剂量60Gy～70Gy;普通CT组用普通CT定位设野,三维适形放疗至相同剂量。结果:PET/CT组的平均PTV体积、膀胱V40、直肠V40均小于普通CT组(P均<0.01);两组放疗后PSA均明显下降(P均<0.01);PET/CT组的中位复发时间12.1个月,普通CT组的中位复发时间9.2个月,两者差异有统计学意义(P<0.01);PET/CT组的胃肠道与膀胱放射性副反应低于普通CT组(P均<0.05);疗前GTV≤50cm^3者预后好。结论:PET/CT定位三维适形放疗中晚期前列腺癌可以优化放疗计划,减少放射副反应,分期早的病变预后好。Objective： To analyze the therapeutic effect and side reactions of 18 FDG PET/CT positioning three-dimensional conformal radiotherapy（3DCRT） for advanced prostate carcinoma. Methods： Sixty-eight cases of prostate carcinoma were randomly divided into ISFDG PET/CT positioning 3DCRT group（ PET/CT group） and the general CT positioning 3DCRT group （ normal CT group）. The lo- cation of patients in PET/CT group was determined by PET/CT and the data was transmitted to the treatment planning system（TPS） ,the PET image and CT image were fused together. The target volume and critical organs were determined and the treatment plan was worked out from the fused image. Then 3DCRT with conventional fraction（40Gy or so） was fallowed by reduced radiation field radiation to reach a total dose of 60Gy -70Gy;The location of patients in normal CT group was determined by normal CT and were treated by 3DCRT to the same dose. Results： The average PTV volume,V40 of bladder and rectum of the PET/CT group were lower than that of the normal CT group （ all P 〈 0. 01 ） ; There was significant difference between the average PSA before and after radiotherapy（ P 〈 0. 01 ） ; The median re- currence time of the PET/CT group was 12. 1 months,and the median recurrence time of the normal CT group was 9. 2 months,there was significant difference between the two groups（P 〈0. 01 ） ;The rate of radiation reactions of gastrointestinal tract and bladder of the PET/ CT group were lower than that of normal CT group（P 〈0. 05） ;The patients with GTV ≤50cm^3 before theatment had better prognosis. Conclusion ： PET/CT positioning 3DCRT can optimize the radiation treatment planning for advanced prostate carcinoma and reduce the radiation side reactions. The patients with early stage lesions have better prognosis than others.

关 键 词：前列腺肿瘤/放射疗法 正电子断层显像 三维适形放射治疗 预后 

分 类 号：R737.25[医药卫生—肿瘤] R730.55[医药卫生—临床医学]