基于PET图像勾画靶区在胰腺癌高剂量少分次放疗中的应用及临床意义  被引量:2

Clinical efficacy of high-dose hypofractioned radiotherapy with referencing PET to delineate target areas for patients with pancreatic cancer

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作  者:任刚[1] 王颖杰[1] 邸玉鹏[1] 常冬姝[1] 李平[1] 李宏奇[1] 王轩[1] 庞海峰[1] 康晓黎[1] 朱夫海[1] 吴伟章[1] 刘纤 夏廷毅[1] 

机构地区:[1]中国人民解放军空军总医院肿瘤放疗科,北京100142

出  处:《肿瘤》2016年第1期77-82,共6页Tumor

基  金:首都卫生发展科研专项(编号:2014-1-5124);中国人民解放军空军总医院面上项目(编号:KZ2014037)~~

摘  要:目的:评价胰腺癌高剂量少分次放疗中基于PET勾画靶区的疗效及不良反应。方法:研究对象为经病理学确诊的Ⅲ期胰腺癌初诊患者,放疗前均接受PET/CT检查,采用PET与定位CT图像融合的方式勾画靶区,并采用螺旋断层放疗设备进行放疗(计划靶体积放疗剂量为50 Gy,大体肿瘤体积放疗剂量为65~70 Gy;分割次数为15~20次)。对患者进行随访,观察放疗疗效及不良反应,并进行生存分析。结果:31例患者中,男性19例,女性12例;中位年龄为60岁;中位肿瘤体积为51.66 cm^3。近期局部控制率为87.1%,疼痛缓解率为92.3%;急性3级血液学不良反应和消化系统不良反应备1例(3.2%),晚期3级消化系统不良反应3例(9.7%)。中位随访时间为24个月,中位生存期为15个月,1年生存率为52.4%。年龄、KPS评分及同步放化疗是独立的预后因素(P值均<0.05)。结论:在胰腺癌高剂量少分次放疗中,基于PET图像勾画靶区进行放疗,可能使患者的生存获益。Objective: To observe the efficacy and adverse events of high-dose hypofractioned radiotherapy with areas for patients with pancreatic referencing PET to delineate target cancer. Methods: The patients with pathologically-diagnosed stage III primary pancreatic cancer were recruited in this study. All patients underwent PET/CT examination before treatment. PET image was merged to CT image to delineate target areas. The dose mode was 50 Gy for planning target volume (PTV) and 65-70 Gy for gross tumor volume (GTV) in 15-25 fractions with tomotherapy system (TOMO). The efficacy and toxicity of the treatment were observed during follow-up. The survival analysis was conducted. Results: Of 31 patients with pancreatic cancer, 19 were males, and 12 were females; the median age was 60 years; the median volume of tumor was 51.66 cm3. The short-term local control rate was 87.1%, and the rate of cancer pain relief was 92.3%. Grade 3 acute hematologic toxicity was observed in one case (3.2%) and grade 3 digestive tract side reaction was observed in one case (3.2%). Grade 3 later digestive tract side reaction was observed in 3 cases (9.7%). The median follow-up time was 24 months. The median survival time was 15 months, and one-year survival rate was 52.4%. Survival analysis showed that age, KPS score and concurrent chemoradiotherapy were independent prognostic factors (all P 〈 0.05). Conclusion: Delineating target areas based on PET image may be beneficial to improve the prognosis of patients with pancreatic cancer receiving high-dose hypofractioned radiotherapy.

关 键 词:胰腺肿瘤 放射疗法 正电子发射计算机断层摄影术 高剂量少分次放疗 预后 

分 类 号:R735.9[医药卫生—肿瘤] R730.55[医药卫生—临床医学]

 

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