^18F-FDG-PET/CT早期预测鼻咽癌放疗疗效的应用价值

目的18F-FDG-PET能否早期监测放疗疗效目前仍有争议,放射治疗后何时行18F-FDG-PET检查既能评价放疗响应又能排除放疗引起放射性炎症对检查结果的影响,仍没有统一标准。本研究旨在研究^18F-FDG-PET对评价鼻咽鳞癌早期放疗响应的临床价值。方法自2009年3月至2009年11月,我院入组的32例确诊的初治鼻咽鳞癌患者,所有患者在治疗前一周和放疗中（DT50Gy/25F,5W）及放疗结束（DT70Gy/25F,7W）后1周内分别行18F-FDG-PET/CT检查,分别计算相关指标。结果32例患者中与放疗前相比,放疗中及放疗结束一周内SUVmax均明显下降,治疗前（单纯放疗或放化疗同步治疗）原发病灶SUVmax值平均值为（12.1±5.51）（2.70～24.5）,放中SUVmax值平均值为（3.69±1.97）（1.3～7.60）,放疗结束一周内SUVmax值平均值为（3.06±1.63）（1.20～7.50）。三组数据均提示放疗过程中^18F-FDG最大标准摄取值（SUVmax）逐步降低（P〈0.001）。结论^18F-FDG-PET可能能够早期监测鼻咽癌放疗响应,有利于决定下一步治疗方案,作为设计放疗总剂量或综合应用手术、化疗提供一些依据。

Clinical value of 18F-FDG-PET/CT for early predicting radiotherapy response in patients with nasopharyngeal carcinoma

Objective Disputes are existing about Monitoring efficiency of ^18F-FDG to Radiotherapy Efficacy early.It is difficult to Select reasonable ^18F-FDG-PET test time that not only can evaluate radiotherapy response but also can eliminate affect of radioactive inflammation.To investigate the clinical value of ^18F-FDG-PET/CT in early detecting radiotherapy response of NPC during radiotherapy.Methods Thirty-two patients with nasopharyngeal carcinoma during three-dimensional conformal radiotherapy were enrolled into the study.18F-FDG-PET/CT imaging were performed at one week before radiotherapy,during radiotherapy of 50 Gy,and 1-2 d after radiotherapy respectively.The maximum standardize uptake value （SUVmax） was calculated for 18F-FDG-PET/CT imaging,and global tumor volume （GTV） was drawn using AW software system.Results The SUVmax of radiotherapy patients were gradually decreased during and after radiotherapy.The SUVmax before,during and after radiotherapy were 12.1±5.51,3.69±1.97 and 3.06±1.63 respectively.There was significant statistical difference between these three groups （P〈0.001）.Conclusion 18F-FDG-PET/CT may early detect radiotherapy response of NPC,help to decide the next treatment plan,and provide valuable information for planning radiotherapy total dose.