MSCT在含铂双药方案全身化疗治疗非小细胞肺癌的疗效评价中的应用价值

Application of MSCT in Evaluating the Efficacy of Systemic Platinum-based Combination Chemotherapy for Non-small Cell Lung Cancer

目的探讨多层螺旋CT(MSCT)在含铂双药方案全身化疗治疗非小细胞肺癌(NSCLC)的疗效评价中的应用价值。方法回顾性分析2015年1月—2018年1月我院收治的86例NSCLC患者的临床资料,所有患者均采用含铂双药方案全身化疗,并分别于治疗前和治疗2个周期后行MSCT增强扫描和灌注成像。根据疗效将患者分为缓解组和未缓解组,记录并比较两组患者治疗前后病灶增强扫描期间不同时相的CT值,以及CT灌注参数,包括血流量(BF)、血容量(BV)、表面渗透性(PS)、平均通过时间(MTT)、到达峰值时间(TP)。结果 86例患者中,CR 18例(20.93%)、PR 24例(27.91%)、SD 23例(26.74%)、PD 21例(24.42%),缓解率为48.84%。两组患者治疗前后增强CT扫描25 s、60 s时相的CT值均显著高于0 s时相(P<0.05)。未缓解组治疗前后扫描0 s、25 s、60 s时相的CT值比较,差异无统计学意义(P>0.05);缓解组治疗后扫描0 s、25s、60 s时相的CT值均显著低于治疗前,并显著低于未缓解组(P<0.05)。未缓解组患者治疗前后CT灌注参数BF、BV、PS、MTT、TP比较,差异无统计学意义(P>0.05);缓解组患者治疗前BF、BV显著高于未缓解组(P<0.05),治疗后BF、BV、PS显著低于治疗前,并显著低于未缓解组(P<0.05),MTT显著高于治疗前,并显著高于未缓解组(P<0.05)。结论 MSCT增强扫描和灌注成像可反映肿瘤体积和血管功能变化,对NSCLC患者化疗疗效的评价具有较高的应用价值。

Objective To explore the application value of multi-slice spiral CT (MSCT) in evaluating the efficacy of systemic platinumbased combination chemotherapy in the treatment of non-small cell lung cancer (NSCLC). Methods The clinical data of 86 patients with NSCLC admitted to our hospital between January 2015 and February 2018 were retrospectively analyzed. All patients were given platinumbased combination regimen for systemic chemotherapy, and they were given CT-enhanced scans and perfusion imaging before treatment and after two cycles of treatment. According to the efficacy, the patients were divided into remission group and non-remission group. The CT values of different time phases during lesion enhancement scan before and after treatment were recorded in the two groups. The CT perfusion parameters, including blood flow (BF), blood volume (BV), permeability surface (PS), mean transit time (MTT) and time-to-peak (TP), were observed and compared. Results Among the 86 patients, there were 18 cases (20.93%) of CR, 24 cases (27.91%) of PR, 23 cases (26.74%) of SD and 21 cases (24.42%) of PD with the remission rate of 48.84%. The CT values at 25s and 60 s enhanced CT scan before and after treatment in the two groups were higher than those at 0 s (P<0.05). There were no significant differences in the CT values at 0s, 25s and 60s scan before and after treatment in non-remission group (P>0.05). But in remission group, the CT values at 0 s, 25 s and 60 s scan phases after treatment were lower than those before treatment (P<0.05), and were lower than those in non-remission group (P<0.05). No significant differences were observed in the parameters of BF, BV, PS, MTT and TP in non-remission group before and after treatment (P>0.05). Before treatment, the BF and BV in remission group were higher than in non-remission group (P<0.05). But after treatment, the BF, BV and PS were lower in remission group than in non-remission group (P<0.05), and were also lower than those before treatment (P<0.05). The MTT in remission group was higher than that before treatment, and also higher than in non-remission group (P<0.05). Conclusion MSCT enhanced scan and perfusion imaging can reflect tumor volume changes and vascular function changes. It has a high application value in the evaluation of chemotherapy efficacy for patients with NSCLC.