CAJ | 학술논문

目的通过18F-脱氧葡萄糖正电子发射断层-X线计算机体层成像(18F-FDG PET-CT)最大标准化摄取值(SUVmax)在鼻咽癌放疗过程中的动态变化,探讨其早期评价鼻咽癌患者放疗过程的生物代谢反应的可能性.方法 60例经病理确诊的初治鼻咽癌患者,于放疗前1周、放疗50 Gy时、放疗结束时和放疗结束后1个月行18F-FDG PET-CT检查,分析SUVmax与病理类型的关系.结果随着放疗的进行,鼻咽原发灶的SUVmax逐渐下降(P＜0.001),放疗前、放疗50 Gy时、放疗结束时和放疗结束后1个月的SUVmax分别为11.20±5.37、3.50±1.59、3.05±1.56和2.52±1.46.鼻咽原发灶中,非角化型未分化癌和非角化型低分化癌的放疗前SUVmax分别为12.35±5.79和9.35±4.19(P =0.038)；放疗50Gy时,△SUVmax分别为(67±19)％和(55±24)％(P=0.046).结论在放疗早期采用18F-FDG PET-CT评价放疗敏感性是可能的,但还需结合长期随访结果进行分析.
목적 통과18F-탈양포도당정전자발사단층-X선계산궤체층성상(18F-FDG PET-CT)최대표준화섭취치(SUVmax)재비인암방료과정중적동태변화,탐토기조기평개비인암환자방료과정적생물대사반응적가능성.방법 60례경병리학진적초치비인암환자,우방료전1주、방료50 Gy시、방료결속시화방료결속후1개월행18F-FDG PET-CT검사,분석SUVmax여병리류형적관계.결과 수착방료적진행,비인원발조적SUVmax축점하강(P＜0.001),방료전、방료50 Gy시、방료결속시화방료결속후1개월적SUVmax분별위11.20±5.37、3.50±1.59、3.05±1.56화2.52±1.46.비인원발조중,비각화형미분화암화비각화형저분화암적방료전SUVmax분별위12.35±5.79화9.35±4.19(P =0.038)；방료50Gy시,△SUVmax분별위(67±19)％화(55±24)％(P=0.046).결론 재방료조기채용18F-FDG PET-CT평개방료민감성시가능적,단환수결합장기수방결과진행분석.
Objective The primary aim of this prospective study was to use serial 18F-FDG PET-CT imaging to evaluate the trend of the tumor's maximum standardized uptake value (SUVmax) during radiotherapy (RT) for patients with nasopharyngeal carcinoma (NPC),and to explore the possibility of early evaluation of the tumor bio-metabolic response during radiotherapy.Methods Sixty patients with biopsyproven primary NPC were prospectively enrolled into the study.All patients underwent four 18F-FDG PET-CT scans:one initial scan before RT/cisplatin based concurrent chemoradiotherapy,at the point of 50 Gy during RT,the end of RT,and one month after RT,respectively.Tumor 18F-FDG uptake was analyzed acording to the World Health Organization pathological type.Results There was a significant difference (P ＜0.001 ) of the mean of SUVmax of the primary site among pretreatment ( 11.20 ± 5.37 ) and posttreatment at the dose of 50 Gy (3.50 ± 1.59 ),at the end of RT ( 3.05 ± 1.56 ) and one month after RT (2.52 ± 1.46).There was also a significant difference ( P ＜ 0.001 ) of the mean of SUVmax of neck node site.However,there was a significant difference of the SUVmax between histological WHO type Ⅱb and type Ⅱa in the primary site (P =0.046 ) [ (67 ± 19) ％ reduction at dose 50 Gy for type Ⅱ b vs.(55 ± 24 ) ％ for type Ⅱ a ] but not in the lymph nodes.Conclusions Early PET scan during or right after RT instead of conventional 3 months interval after RT is indicated to evaluate the tumor response and to develop individualized adaptive radiotherapy in NPC.Our next study will attempt to demonstrate the results based on long-term follow-up data.