脱氧葡萄糖PET-CT预测食管鳞癌三维放疗远期疗效研究  

Value of 18 F-FDG PET-CT in predicting long-term response to three-dimensional radiotherapy inpatients with esophageal squamous cell carcinoma

作　　者：巩合义[1] 李万湖[1] 黄伟[1] 付政[1] 伊艳[1] 孙洪福[1] 李宝生[1] 

机构地区：[1]山东省放射肿瘤学重点实验室山东省肿瘤医院放疗六科,济南250117

出　　处：《中华放射肿瘤学杂志》2013年第2期123-127,共5页Chinese Journal of Radiation Oncology

摘　　要：目的探讨氟脱氧葡萄糖PET-CT预测食管鳞癌三维放疗无进展生存（PFS）、总生存（OS）的价值。方法回顾分析本院2004--2010年氟脱氧葡萄糖PET-CT检查后行三维放疗的98例食管鳞癌患者1、3、5年PFS、OS，分析标准摄取值（SUV）、代谢体积（MTV）、放疗前PET-CT原发灶长度、PET病灶个数与PFS、OS关系。对SUV与临床资料行独立样本t检验或HotellingT2检验，Kaplan-Meier法计算生存率并Logrank法检验，Cox模型分析预后影响因素。结果随访率为100％，其中随访时间满3、5年者分别为56、27例。原发灶SUVmax、SUVmean、MTV、放疗前PET-CT原发灶长度、PET病灶个数均与PFS、OS相关（X2=8．99～41．82，P均〈0．01）。Cox模型预后分析显示SUVmean。（X2=4．41，P=0．036，RR=1．398）、PET病灶个数（X2=6．79，P=0．009，RR=3．650）可较好预测PFS，而PET病灶个数（X2=5．03，P=0．025，RR=3．740）可较好预测Os。结论预测食管鳞癌精确放疗远期疗效时可选择SUVmean、PET病灶个数预测PFS，选择PET病灶个数预测OS。Objective To investigate the value of 18 F-fluorodeoxyglucose （FDG） positron emission tomography （PET）-computed tomography （CT） in predicting the progression-free survival （PFS） and overall survival （OS） of patients with esophageal squamous cell carcinoma （ESCC） after three- dimensional （3D） radiotherapy. Methods A retrospective analysis was performed on 98 ESCC patients, who underwent FDG PET-CT before 3D radiotherapy from 2004 to 2010, to investigate their 1-, 3-, and 5- year PFS and OS rates. The relationship of maximum standard uptake value （SUV ）, mean SUV （ SUV ）, metabolic target volume （ MTV）, length of primary tumor on PET-CT before radiotherapy, and number of tumors on PET with PFS and OS were analyzed. The SUVs and clinical data were analysed by independent samples t-test or Hotelling T2 test ; the Kaplan-Meier method was used for calculating PFS and OS rates, and the Logrank test was used for survival difference analysis;the prognostic factors were analysed using the Cox proportional hazard model. Results The follow-up rate was 100% ;56 patients were followed up for at least 3 years, and 27 for at 5 years. The SUV SUV and MTV of primary tumor, length of primary tumor on PET-CT before radiotherapy, and number of tumors on PET were correlated with PFS and OS （ X2 = 8.99---41.82, all P 〈 0. 01 ）. The Cox regression analysis showed that PFS could be well predicted based on SUV （ X2 = 4. 41, P = 0. 036, RR = 1. 398 ） and number of tumors on PET （ X2 = 6. 79, P = 0. 009, RR = 3. 650） and that OS could be well predicted based on number of tumors on PET （X2 = 5.03, P = 0. 025, RR = 3. 740）. Conclusions When estimating the long-term response to precise radiotherapy in patients with ESCC, SUV and number of tumors on PET may be used to predict PFS, and number of tumors on PET may be used to predict OS.

关 键 词：食管肿瘤 三维放射疗法 氟脱氧葡萄糖 体层摄影术 正电子发射型 预后 

分 类 号：R735[医药卫生—肿瘤] R730[医药卫生—临床医学]