NSCLC溶骨型脊柱转移瘤21例放疗前后CT影像对比  

A comparative CT study of the effect of radiotherapy on the treatment of osteolytic spinal metastases of non-small cell lung cancer patients

作　　者：沈莲 冯卫华[3] 陈莉[4] 韩斌丽 王洪真[2] SHEN Lian1,3, FENG Weihua2 , CHEN Li4 , HAN Binli4 , FANG Hongzhen3(1. Qingdao University, Qingdao Shandong 266003, P. R. China;2. Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao 266003, P. R. China;3. Department of Oncology, Rizhao TCM Hospital, Rizhao 276800, P. R. China;4. Department of MRI, Rizhao TCM Hospital, Rizhao 276800, P. R. China)

机构地区：[1]青岛大学,山东青岛266003 [2]山东省日照市中医医院肿瘤科,山东日照276800 [3]青岛大学附属医院放射科,山东青岛266003 [4]山东省日照市中医医院磁共振室,山东日照276800

出　　处：《医学影像学杂志》2018年第9期1530-1534,共5页Journal of Medical Imaging

摘　　要：目的探讨NSCLC溶骨型脊柱转移瘤放射治疗前后在CT表现的变化特点。方法回顾性分析21例NSCLC溶骨型脊柱转移瘤患者的放射治疗及影像学资料,观察溶骨型脊柱转移瘤CT影像特点及其放疗后1月、3月、6月的椎体转移瘤CT值及体积值变化,总结其特征。结果所有患者均顺利完成治疗及影像学CT检查,溶骨型椎体转移病灶放疗后1个月病灶内未见明显钙化,CT值变化差异无统计学意义(P> 0. 05); 3个月、6个月后病灶同部位CT值与放疗前相比显著升高(P=0. 04,P=0. 017)。本组中所有病灶在放疗6个月后CT检查评价为CR 2例,PR 9例,NR 8例,PD 2例,总有效率52. 3%,38. 1%的患者病灶表现稳定。结论在NSCLC溶骨型脊柱转移病灶的治疗中,放射治疗可以有效杀灭肿瘤细胞、促进溶骨性病灶钙化修复,对患者具有相当肯定的疗效; CT检查是一种观察骨转移灶放疗后影像学变化的安全有效的常规检查手段。Objective To explore the characteristics of the CT images before and after the radiotherapy of NSCLC osteolytic spinal metastases. Methods The radiotherapy and imaging data of 21 patients with NSCLC osteolytic spinal metastases were ret- rospectively analyzed. The CT values and volume changes in 1 month, 3 months, and 6 months after radiotherap were employed to assess the radiotherapy effect. Results All patients successfully completed the treatment and imaging CT examination. On 1 month after the radiotherapy, there was no significant calcification at the lesion site, and there was no significant change of the CT values （ P 〉 0.05）. On 3 months or 6 months after the radiotherapy, the CT value of the same site was higher than that before radiotherapy （ P =0.04, P =0.017）. The CT images of all lesions were evaluated 6 months after the radiotherapy, with results showing 2 cases of CR, 9 cases of PR, 8 cases of NR, and 2 cases of PD. The total efficiency was 52.3% , while 38.1% of the patients showed no change. Conclusion Radiotherapy can effectively kill tumor cells and promote the calcification repair of osteolytic lesions in the treatment of NSCLC osteolytic spinal metastases patients. CT is a safe and effective routine examination method for revealing imaging changes in bone metastases after radiotherapy.

关 键 词：肺肿瘤 非小细胞肺癌 脊柱转移瘤 放射治疗 体层摄影术 X线计算机 

分 类 号：R738.1[医药卫生—肿瘤] R814.42[医药卫生—临床医学]