CT灌注参数变化在预测中晚期肺癌放化疗疗效的价值

The Value of CT Perfusion Parameter Changes in Predicting the Efficacy of Radiotherapy and Chemotherapy in Advanced Lung Cancer

目的:通过观察基线与化疗3周期后CT灌注参数的变化,评估其在预测中晚期肺癌化疗预后的价值。方法:选取2020年2月至2023年10月我院收治的66例中晚期肺癌患者作为研究对象,均予以全身化疗联合放疗方案治疗,按临床疗效不同分为缓解组和未缓解组。治疗前后每组进行CT灌注扫描,对采集到的CT灌注参数进行分析,评估其对患者效果的应用情况。观察两组患者肿瘤组织血流量、肿瘤组织血容量、表面通透性变化情况对预后的影响。结果:放化疗前与放化疗后患者早期肿瘤大小相比差异无统计学意义(P>0.05),缓解组与未缓解组相比,肿瘤病灶大小均无统计学意义(P>0.05)。放化疗前与放化疗后患者早期肿瘤大小相比差异无统计学意义(P>0.05),缓解组与未缓解组相比,肿瘤病灶大小均无统计学意义(P>0.05)。缓解组BE、PEI值水平显著高于未缓解组,BV、PS值水平低于未缓解组,差异有统计学意义(P<0.05)。缓解组生存期显著高于未缓解组(P<0.05)。多因素Logistic回归分析表明PS值是患者预后的独立危险因素,PEI值为患者预后的独立保护因素(P<0.05)。结论:基线与化疗3周期后CT灌注参数的变化特别是PS值在中晚期肺癌化疗预后评估中具有一定的价值,可作为预测放化疗效果和预后的参考指标。

Objective:To evaluate the value of CT perfusion parameters in predicting the chemotherapy prognosis of mid to late stage lung cancer by observing changes in baseline and CT perfusion parameters after 3 cycles of chemotherapy.Methods:66 patients with advanced lung cancer admitted to our hospital from February 2020 to October 2023 were selected as the study subjects,all of whom were treated with a combination of systemic chemotherapy and radiotherapy.Clinical efficacy was evaluated,and they were divided into remission group and non remission group according to different clinical efficacy.Before and after treatment,CT perfusion scans were performed in each group to analyze the collected CT perfusion parameters and evaluate their application in patients.Observe the impact of changes in tumor tissue blood flow,tumor tissue blood volume,and surface permeability on prognosis in two groups of patients.Results:There was no statistically significant difference in early tumor size between patients before and after radiotherapy and chemotherapy(P>0.05),and there was no statistically significant difference in tumor lesion size between the remission group and the non remission group(P>0.05).There was no statistically significant difference in early tumor size between patients before and after radiotherapy and chemotherapy(P>0.05),and there was no statistically significant difference in tumor lesion size between the remission group and the non remission group(P>0.05).The BE and PEI values in the remission group were significantly higher than those in the non remission group,while the BV and PS values were lower than those in the non remission group,with statistical significance(P<0.05).The survival time of the remission group was significantly higher than that of the non remission group(P<0.05).Multivariate logistic regression analysis showed that PS value is an independent risk factor for patient prognosis,and PEI value is an independent protective factor for patient prognosis(P<0.05).Conclusion:The changes in CT perfusion parameters after baseline and 3 cycles of chemotherapy,especially PS value,have certain value in the evaluation of chemotherapy prognosis for mid to late stage lung cancer,and can be used as a reference indicator for predicting the effectiveness and prognosis of radiotherapy and chemotherapy.