^(18)F-FDG PET/CT在晚期肺癌三维适形放疗的靶区勾画中的价值及对短期疗效和预后的影响  

Application of 18F-FDG PET/CT in planning three-dimensional conformal radiotherapy and short-term prognostic and survival analysis for advanced non-small cell lung cancer

作　　者：梁英魁[1] 康静波[2] 郭烽[1] 雷霄[1] 王新强[1] 赵文锐[1] 赵向飞[2] 王伟[2] 孔垂林 

机构地区：[1]海军总医院核医学科,北京100048 [2]海军总医院放射肿瘤科,北京100048

出　　处：《临床和实验医学杂志》2017年第13期1337-1341,共5页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨^(18)F-FDG PET/CT在晚期非小细胞肺癌(NSCLC)三维适形放疗(3DCRT)的靶区勾画中的价值及对短期疗效评价和1年生存率的影响。方法将56例NSCLC临床Ⅲ期的患者分为PET/CT引导定位组(PET/CT组,26例)和普通CT定位组(CT组30例)。PET/CT组将PET和CT图像融合后进行靶区和重要脏器勾画,制定治疗计划后进行相应3DCRT治疗。CT组用普通CT定位,治疗同上。所有病例均用TP方案辅助化疗6个周期。结果随访率100%。随访满1年者共计39例,PET-CT组和CT组分别为19和20例。治疗计划显示应用PET/CT勾画大体肿瘤体积(GTV)与计划靶区体积(PTV)均小于CT勾画的靶区(t=3.712,P<0.05;t=9.430,P<0.05)。PET//CT组和CT组短期疗效有效率分别为80.7%vs.70.0%(P=0.537),1年局部控制率分别为69.2%vs.56.7%(P=0.412),1年生存率分别为73.1%vs.66.7%(P=0.772)。PET-CT组肺门、纵隔淋巴结复发率(1年内)低于CT组,分别为11.5%vs.36.7%(P=0.036);治疗失败主要原因均为远处转移,分别为42.3%vs.53.3%(P=0.436)。结论与CT相比,PET/CT引导定位可以优化晚期NSCLC放疗设野计划,略微提高短期疗效,明显降低肺门、纵隔淋巴结复发率,而1年期生存率无明显提高。Objective To evaluate the value of 18F-FDG PET/CT in planning three-dimensional conformal radiotherapy（3DCRT） and the effect on short-term therapy result and 1-year survival rate for stage Ⅲ non-small cell lung cancer （NSCLC）.Methods Fifty-six cases in stage Ⅲ NSCLC（clinical stage Ⅲa and Ⅲb）were divided into two groups：PET/CT positioning 3DCRT group（PET/CT group,26 cases）and the conventional CT positioning 3DCRT group （CT group,30 cases）.In the PET/CT group,the target volume and critical organs were sketched according to PET/CT after fusion of the PET and the CT images and then the treatment plans were worked out.In the conventional CT group,the target volume and critical organs were sketched according to CT and 3DCRT were performed to the same way.All cases were treated with the TP scheme adjutant chemotherapy for 6 cycles after the radiotherapy.Results The follow-up rate was 100%.The number of cases who completed follow-up for one year was 39 （19 cases in PET/CT group and 20 cases in CT group,respectively）.In PET/CT group,the sizes of gross target volumes （GTV） and planning target volumes （PTV） by PET/CT were both smaller than that by CT （t=3.712,P＆lt;0.05 and t=9.430 P＆lt;0.05,respectively）.The short-term effective rates of therapy （3 months） of the two groups were 80.7% and 70.0% （P=0.537）.The 1-year local control rate and the 1-year survival rate of the two groups were 69.2 vs.56.7% （P=0.412） and 73.1% vs.66.7% （P=0.772）,respectively.The hilar and mediastinal lymph node 1-year recurrence rates of the PET/CT group were lower than those of the conventional CT group （11.5% vs.36.7%,P=0.036）.The main reason for treatment failure was distant metastasis both in two groups （42.3% vs.53.3%,P=0.436）.Conclusion Compared with conventional CT,PET/CT,as a new method of imaging guiding 3DCRT in advanced NSCLC,can improve the radiation treatment plan,reduce the recurrence rate of hilar and mediastinal lymph nodes and evaluate the short-term effect,wh

关 键 词：非小细胞肺癌 三维适形放射疗法 PET/CT 靶区勾画 短期疗效 预后 

分 类 号：R730.44[医药卫生—肿瘤] R734.2[医药卫生—临床医学]