动态增强磁共振预测鼻咽癌原发灶化疗疗效的临床研究  

Clinical Studies on the Prediction of Chemotherapeutic Efficacy for the Primary Lesion of Nasopharyngeal Carcinoma by Dynamic Contrast-Enhanced Magnetic Resonance

作　　者：翁克贵[1,2,3] 吴伟莉[1,2] 金风[1,2] 陈海霞[1,2] 李媛媛[1,2] 龙金华[1,2] 陈潇潇[1,2] 刘梅[1,2] 戚正君[1,2] 雷鹰[4] 

机构地区：[1]贵阳医学院附属医院头颈肿瘤科 [2]贵州省肿瘤医院头颈肿瘤科,贵阳市550000 [3]重庆市肿瘤研究所 [4]贵州省肿瘤医院影像科

出　　处：《中国肿瘤临床》2012年第24期2036-2039,共4页Chinese Journal of Clinical Oncology

基　　金：贵州省科技厅社会发展攻关计划项目(编号:黔科合LG字[2012]041号)资助~~

摘　　要：目的:探讨动态增强磁共振成像在局部晚期鼻咽癌化疗疗效预测中的价值,为进行个体化治疗提供依据。方法:64例2010UICC分期为Ⅲ～Ⅳb期的初治鼻咽癌患者,行TPF方案诱导化疗3周期。诱导化疗前行DCE-MR检查,获取造影剂到达组织时间(T_1 on set),造影剂到达强化高峰时间(TTP),最大信号强度值(SI),强化峰值(PV),强化百分数(SI%)等参数,将其与诱导化疗后肿瘤缩小率进行相关性分析。结果:1)诱导化疗后鼻咽癌原发灶PR24例,NC40例。2)鼻咽癌原发灶缩小率与T_1 on set(r=-0.378,P<0.001)及TTP(r=-0.285,P=0.02)负相关;与SI(r=0.027,P=0.834)、PV(r=0.042,P=0.741)、SI%(r=0.026,P=0.841)无明确相关关系。结论:造影剂到达组织及达到强化高峰时间早的病例化疗后肿瘤缩小率大;肿瘤强化程度与化疗后肿瘤缩小率无相关性;T_1 on set、TTP有可能作为鼻咽癌化疗疗效预测指标之一。Objective： To investigate the value of dynamic contrast-enhanced magnetic resonance （DCE-MR） in predicting the chemotherapy efficacy of locally advanced nasopharyngeal carcinoma, thereby providing a more reliable basis for making personalized treatment plans. Methods： Sixty-four patients were pathologically diagnosed as having nasopharyngeal carcinoma in stage III -IVb 2010UICC. They were treated by TPF regimen （Docetaxel＋Cisplatin＋ 5-Fluorouracil） in 3 cycles. Before undergoing induction chemotherapy, they received DCM-MRI to obtain the time at arrival of contrast inflow （T 1 on set）, time to peak （TTP）, maximum of signal intensity （SI）, peak value （PV）, and percent of signal intensity （SI%）. The relationship between DCM-MR parameters and tumor regression rate after induction chemotherapy is investigated. Results： 1） A total of 24 cases achieved PR and 40 cases achieved NC. 2）T1 on set and TTP negatively correlated to regression rate of primary tumor （-0.378 and -0.285, P〈0.001 and P=-0.02）. PV （0.027, P=0.834）, SI （0.042, P=-0.741）, and SI% （0.026, P = 0.841） have no correlation with tumor regression rate. Conclusion： 1） Patients with sooner T1 on set and TTP have a greater tumor regression rate. 2）Tumor enhancement degree and tumor regression rate after chemotherapy have no correlation. 3）DCM-MR parameters, such as TTP and T1 on set, can be used to predict the curative effect of induction chemotherapy.

关 键 词：鼻咽肿瘤 磁共振成像 化疗 

分 类 号：R739.63[医药卫生—肿瘤]