氟脱氧葡萄糖γ-相机型PET显像对非小细胞肺癌临床治疗的影响

Influence of ^(18)F -deoxyglucose γ-camera PET imaging on the treatment of non-small cell lung cancer

目的探讨氟脱氧葡萄糖γ-相机型PET(hPET)显像与常规检查相结合对非小细胞肺癌(NSCLC)临床分期的影响,以及由此产生的对治疗策略和放疗靶区的影响。方法49例经病理证实初治的NSCLC、有完整病史、体检和临床分期检查者进入研究。在做hPET前根据病史、临床检查及常规影像学检查进行临床分期并制定一治疗方案。hPET检查后结合其结果重新进行临床分期,再制定一治疗方案,比较在有和没有hPET参与的情况下的临床分期差别以及分期改变对治疗决策的影响,并比较其中伴肺不张者CT和hPET所显示原发肿瘤体积的差异。结果49例中hPET检查前准备行根治性治疗22例,姑息性治疗27例。hPET检查后36.7%(18/49)临床分期有改变,其中分期上升5例,下降13例。36.7%(18/49)治疗决策有变化。对伴肺不张者hPET图像显示肿瘤体积比CT所显示的肿瘤体积平均小17.7%。结论hPET的参与显著影响了NSCLC的临床分期和治疗策略的确定。对伴肺不张者,hPET有望鉴别肺不张和肿瘤。

Objective To investigate the influence of ~~18 F -deoxyglucose γ-camera PET imaging on the clinical staging of non-small cell lung cancer(NSCLC) in comparison to the convention staging as well as the changes in treatment planning and the target area of radiotherapy. Methods Fourty-nine patients with pathologically confirmed NSCLC complete with history,physical examination,routine roentgenography and clinical staging by the conventional method were entered into the present study. An initial staging and treatment plan were established basing on all the above information.After hPET,a revised staging and treatment plan were,then,made.The emphasis of the present study was laid upon the changes in staging and treatment plan with and without the participation of hPET and also upon the difference in the primary tomor volume silhouetted by CT and hPET. Results Before hPET, curative plan was intended for 22 patients and palliative plan for 27 among these 49 patients.After hPET,36.7%(18/49) found their clinical stage changed:5 elevated and 13 lowered.The treatment plan was also changed in 36.7%.The primary tumor volume revealed by CT was reduced in 17.7%(P=0.002) by hPET.Conclusions The participation of hPET obviously influences the clinical staging and treatment planning of NSCLC.It is hopeful that hPET be used in differentiating atelectasis from tumor.