CAJ | 학술논문

目的探讨18F-氟脱氧葡萄糖(FDG)PET-CT显像在Ⅲ期非小细胞肺癌(NSCLC)疗效评价及预后判断中的价值.方法 46例NSCLC患者分别在放疗前1周及放疗剂量达到40～50 Gy时进行18F-FDG PET-CT显像检查,以最大标准摄取值(SUVmax)的变化百分率为50%为分割点,将46例患者分为治疗有反应组(A组)和无反应组(B组),对比分析两组治疗前和治疗中的SUVmax值及其变化率与疗效和预后的关系.结果 A组25例,B组21例.A组和B组治疗前的SUVmax值分别为7.59±3.14和14.72±4.67,治疗中的SUVmax值分别为2.89±1.39和9.82±3.31,两组差异均有统计学意义(均P＜0.05).A组和B组SUVmax值变化百分率分别为61.9%±8.7%和33.6%±9.0%,差异有统计学意义(P=0.007).A组和B组患者的1年生存率分别为68.0%和38.1%,2年生存率分别为64.0%和33.3%,两组差异均有统计学意义(均P＜0.05).Logistic回归分析显示,治疗前和治疗中的SUVmax以及两者的变化百分率与NSCLC患者的预后有关.结论治疗前和治疗中的SUVmax以及两者的变化百分率可作为Ⅲ期NSCLC患者早期疗效评价和预后判断的重要参考指标.
목적 탐토18F-불탈양포도당(FDG)PET-CT현상재Ⅲ기비소세포폐암(NSCLC)료효평개급예후판단중적개치.방법 46례NSCLC환자분별재방료전1주급방료제량체도40～50 Gy시진행18F-FDG PET-CT현상검사,이최대표준섭취치(SUVmax)적변화백분솔위50%위분할점,장46례환자분위치료유반응조(A조)화무반응조(B조),대비분석량조치료전화치료중적SUVmax치급기변화솔여료효화예후적관계.결과 A조25례,B조21례.A조화B조치료전적SUVmax치분별위7.59±3.14화14.72±4.67,치료중적SUVmax치분별위2.89±1.39화9.82±3.31,량조차이균유통계학의의(균P＜0.05).A조화B조SUVmax치변화백분솔분별위61.9%±8.7%화33.6%±9.0%,차이유통계학의의(P=0.007).A조화B조환자적1년생존솔분별위68.0%화38.1%,2년생존솔분별위64.0%화33.3%,량조차이균유통계학의의(균P＜0.05).Logistic회귀분석현시,치료전화치료중적SUVmax이급량자적변화백분솔여NSCLC환자적예후유관.결론 치료전화치료중적SUVmax이급량자적변화백분솔가작위Ⅲ기NSCLC환자조기료효평개화예후판단적중요삼고지표.
Objective To evaluate the value of 18F-FDG PET-CT for assessment of therapeutic response and prediction of patient outcome after concurrent chemoradiotherapy (CCRT) of non-small cell lung cancer (NSCLC). Methods Forty six patients with histologically proven stage Ⅲ NSCLC had two repeated 18 F-FDG PET-CT scans either one week before therapy and at the dose of 40 ～ 50 Gy. The SUVmax and changes of the two groups were compared with ( 1 ) the therapeutic response and (2) treatment results and long-term survival. Results Of the 46 eligible cases, the pretreatment SUVmax of the responding and non-responding groups was 7.59 ± 3.14 and 14.72 ± 4.67, respectively. The midtreatment SUVmax of the two groups was 2.89 ± 1.39 and 9.82 ± 3.31, respectively. Significiant difference ( t = 4.74, P = 0.001 ;t =7.23, P =0. 001 )in SUVmax was observed both before and during treatment. Furthermore, the percentage change of pretreatment and midtreatment SUVmax was △SUVmax= 61.9% ±8.7% and △SUVmax =33.6% ±9.0%, also with a significiant difference between the two groups (t = 2.83, P = 0.007 ). In addition, the 1-year survival rate of the the responding and non-responding groups was 68.0% and 38.1%, respectively.The 2-year survival rate of the two groups was 64.0% and 33.3%, respectively,with a significiant difference between the two groups ( P = 0. 043, P = 0. 038 ). Conclusion 18 F-FDG PET-CT is highly effective in detecting therapeutic response in stage Ⅲ NSCLC patients. The analysis of percentage change of SUVmax provides incremental value in early prediction of therapeutic response and patient outcome.