18F-硝基咪唑丙醇正电子发射断层显像/X线计算机体层成像对食管癌放疗前后乏氧情况的监测及疗效评价

目的 通过18F-硝基咪唑丙醇(18F-fluoromisonidazole,18F-FMISO)正电子发射断层显像/X线计算机体层成像(PET/CT)显像监测食管癌肿瘤组织放疗前后乏氧情况的变化,研究18F-FMISO PET/CT显像在食管癌病人放疗疗效评估中的临床应用价值.方法 选取安徽医科大学第一附属医院放疗科...

The hypoxic condition monitoring and treatment evaluation for esophageal carcinoma before and after radiotherapy by18F-FMISO PET/CT

Objective To evaluate the changes of hypoxic conditions by 18F-FMISO PET/CT imaging before and after radiotherapy for patients with esophageal cancer, and to investigate the value of 18F-FMISO PET/CT imaging in evaluating the efficacy of esophageal cancer radiotherapy.Methods Sixty patients pathologically diagnosed with esophageal cancer admitted to Department of Radiothera-py, the First Affiliated Hospital of Anhui Medical University from August 2016 to August 2017 were selected. All the enrolled patients received 18F-FMISO PET/CT scan one week before radiotherapy and one week after treatment, the changes of hypoxic state were collect-ed and analyzed. The response to radiotherapy was evaluated by the response evaluation criteria in solid tumors (RECIST1.1), which was assigned into complete response (CR), partial response (PR), stabilization (SD) and progression (PD) 3 months after radiotherapy. In this experiment, CR and PR were the effective groups of radiotherapy, SD and PD were the ineffective groups. In addition, hypoxic vol-ume (HV) and primary lesion and metastatic lymph node T/M after radiotherapy were compared with those before radiotherapy to evalu-ate the relationship between hypoxic state and radiotherapy effect.Results The primary tumor T/M and HV(cm3) after radiotherapy was significantly lower than before radiotherapy (T/M:1.83 vs. 2.36,HV:3.11 vs. 4.97, Z=-2.090 and -2.805, P<0.05). The HV of metastatic lymph nodes after radiotherapy was significantly lower than that before radiotherapy (1.22 vs. 1.84, Z=-2.192, P<0.05), but the T/M did not change significantly compared with the previous radiotherapy (1.81 vs. 1.71, Z=-0.866, P>0.05). Of the 60 patients, 42 cases of ef-fective treatment (70%), 18 cases of invalid (30%); and the HV and T/M values of the effective group before treatment were significantly lower than those of the invalid group.Conclusions Radiotherapy can significantly improve the hypoxic condition of esophageal tumor and 18F-FMISO PET/CT imaging is of great significance in predicting and evaluating the radiotherapy efficacy of esophageal cancer.