18F-FDG PET/CT评估体部伽玛刀治疗非小细胞肺癌的疗效研究

目的：通过对比实体瘤治疗疗效PET评价标准（PERCIST）与目前广泛应用的传统实体瘤疗效评价标准（RECIST）在评估体部伽玛刀治疗非小细胞肺癌（NSCLC）疗效上的差异,探讨18F-FDG PET/CT在评估体部伽玛刀治疗NSCLC中的价值.方法：82例NSCLC患者伽玛刀治疗后未行任何抗肿瘤治疗,于伽玛刀治疗前及治疗后3个月行CT及18F-FDG PET/CT检查,分别用RECIST1.1和PERCIST1.0评价标准进行近期疗效评价,并分析两者与总生存期（OS）的相关性.结果：应用RECIST1.1和PERCIST1.0标准评价近期疗效存在显著差异（P=0.0001）;单因素方差分析显示,TNM分期、△SUL及PERCIST是体部伽玛刀治疗NSCLC过程中与OS显著相关的因素,而AV、RECIST、肿瘤位置、年龄、KPS评分以及病理学类型则与OS不相关;多变量Cox比例风险回归分析显示,PERCIST1.0（CMR与非CMR）是预测OS最显著的独立预后因素.结论：应用18F-FDG PET/CT对进行体部伽玛刀治疗的NSCLC患者进行近期及远期疗效评价可能较CT更准确.

Study on using 18F-FDG PET/CT to assess the efficacy of body gamma knife treatment of non-small cell lung cancer

Objective：Discuss the value of 18F-FDG PET / CT in assessing the efficacy of body gamma knife treatment on non-small cell lung cancer by comparing PET Response Criteria in Solid Tumors （PERCIST） and the widely used conventional Response Evaluation Criteria in Solid Tumors （RECIST）.Methods：Eighty-two patients with non-small cell lung cancer who received no other anti-tumor therapies after the gamma knife treatment were studied.Radio therapeutic lesion responses were evaluated using CT and 18F-FDG PET according to the RECIST and PERCIST methods.The CT and PET/CT scans were obtained before and about 3 months after body gamma knife.Associations were statistically analyzed between overall survival and clinic opathologic results.Results：There was a significant difference in response classification between RECIST and PERCIST （Wilcoxon signed-rank test,P=0.0001）.Univariate analysis showed that TNM stage,△SUL and PERCIST were significant factors associated with overall survival in this study,while △V,RECIST,tumor location,age,Karnofsky scores and histology were not.Multivariate Cox proportional hazards regression analysis showed PERCIST1.0 （CMR and non-CMR） is the most significant independent prognostic factor which is able to predict OS.Conclusion：PERCIST might be considered more suitable for evaluation of radio therapeutic response to NSCLC than RECIST