CT影像对肿瘤热疗加放疗的疗效评价  

Evaluation of tumor response to thermoradiation therapy with CT scan

作　　者：孙庆选[1] 夏廷毅[1] 史小丽[1] 王佐仁[1] 崔纪青[1] 

机构地区：[1]空军总医院肿瘤放疗科,北京100036

出　　处：《空军总医院学报》2003年第2期106-108,共3页Journal of General Hospital of Air Force,PLA

摘　　要：目的　探讨 CT影像对肿瘤热疗加放疗疗效评价的价值。　方法　采用超声热疗结合放射治疗 15 7例晚期恶性肿瘤 ,对其中 2 3例治疗后瘤体变化不大 ,但瘤体出现明显液化坏死的病例通过增强 CT扫描随访观察 ,按瘤体内低密度区范围和瘤体内有无增强评价疗效。　结果　治疗后按实体瘤评价疗效 ,完全缓解 (CR)为 0 /2 3,部分缓解 (PR)为 18/2 3,无变化(NC)为 5 /2 3。按 CT影像上低密度区域占肿瘤的百分比评价疗效 :完全缓解 (CR,低密度区域占瘤体的 80 %～ 10 0 % )为10 /2 3;部分缓解 (PR,低密度区占瘤体的 5 0 %～ 80 % )为 10 /2 3;无变化 (NC,低密度区占瘤体的 0～ 5 0 % )为 3/2 3。10例 CR病人中 ,9例治疗病灶稳定 ,12～ 2 4个月未见复发 (另一例因手术切口不愈 ,仅存活 3个月 ) ,其中有 3例行瘤体穿刺活检、1例行肿块切除 ,病理结果均为凝固性坏死 ,未查到肿瘤细胞 ;10例 PR病人中 ,8例治疗后 6～ 12个月内局部复发 ,2例 12个月后复发 ;3例 NC的病人在疗后 3个月局部复发。　结论　对热疗结合放射治疗后的局部肿瘤的疗效评价 ,需结合瘤体大小变化和CT影像上肿瘤内的低密度区变化综合评价。Objective To investigate the value of CT scanning in evaluating the tumor response to thermoradiation therapy. Methods The combination of ultrasound hyperthermia and radiotherapy was used in 157 patients with advanced malignancies, of which, 23 having little change in mass size but with obvious liquefaction and necrosis after treatment were followed up for 6～24 months with enhanced CT scan. The effects were evaluated by range of low density area and by level of enhancement on CT scan. Results According to WHO evaluation of tumor response, CR, PR and NC were 0/23, 18/23 and 5/23 respectively , comparing with CR 10/23 (80%～100%)?PR 10/23 (50%～80%) and NC 3/23 (0%～50%) evaluated by percentage of low density area on CT scanning. Of 10 CR patients, 9 were stable and no recurrence in 12～24 months after treatment (1 case was only survival for 3 months for the incision not healing up), and of 3 cases were punctured for biopsy and that of 1 was resected, with pathology showed coagulation necrosis and no tumor cell; of 10 PR patients, 8 locally recurred in 6～12 months, 2 recurred 12 months later; and 3 NC patients locally recurred 3 months later. Conclusion For local tumor treated with hyperthermia plus radiotherapy, the evaluation should be based on changes of both the mass size and of the low density area.

关 键 词：CT影像 肿瘤 热疗 放疗 疗效评价 治疗 

分 类 号：R730.5[医药卫生—肿瘤]