摘要
目的分析应用胸部18FDG-PET影像对高龄非小细胞肺癌实施三维适形放射治疗效果。方法2000年4月至2004年11月间对23例70岁以上非小细胞肺癌患者实施了三维适形放射治疗。患者年龄70～87岁,中位年龄82岁。全组的肺功能评价均为中、重度阻塞性通气功能障碍。参照18FDG-PET影像勾画靶取区,处方剂量为40～60 Gy,应用DVH进行靶体积和关键器官和结构的剂量评价。严格控制心脏和肺所接受的平均剂量,全组患者的治疗计划DVH评价显示,患侧肺的V20范围为20%～45%。结果全组存活时间为6～31个月,中位存活时间为10个月。1年存活率为69%。已经死亡的8例中,有6例(75%)死于肺部感染、呼吸衰竭。结论本组有90%以上的患者获得了临床症状的缓解和生活质量的改善,提示对此组患者采用三维适形放射治疗进行准确的局部照射可以获得较好的姑息治疗效果。对于高龄肿瘤患者这一组特殊的病例,借助于PET生物影像学信息实施安全、精确、合理的放射治疗方案,可以将治疗益处最大化,将治疗危险最小化,获得较为满意的临床效果。
Objective To study the efficacy of 3D-CRT （3-dimensional conformal radiation therapy） based on ^18FDG-PET for the palliative treatment of lung cancer in aged patients. Methods During April 2000 to November 2004,23 patients with nonsmall cell lung cancer aged 70 - 87 years old were treated by 3D-CRT. 3D-CRT with prescription dose 40 - 60 Gy. Results The median survival time of patients was 10 months and the 1-year survival was 69 % （Kaplen-Meier analysis）. Eight patients dead and 6 （75 %） dead of inflammatory pneumonia. Conclusion It is considerable to get the balance of quality of life and survival in aged patients with inopratable lung cancer. Therefore according to the information of ^18FDG-PET imaging this group of patients were treated with conservetive management. It is suggested that the treatment options should be tailored to aged patients based on the same selection process,and PET biological imaging should be adapted for scheduling the rational radio therapeutic program in order to get the successful clinical effects maximize the efficacy and minimize the risks.
出处
《生物医学工程与临床》
CAS
2005年第5期283-285,共3页
Biomedical Engineering and Clinical Medicine
