摘要
目的观察PET／CT对合并肺不张NSCLC治疗方案制定和放疗靶区勾画的影响。方法对拟行根治性3D．CRT的36例伴有不同程度肺不张的NSCLC患者行PET／CT扫描，观察PErr／cT对其临床分期的影响，及由此带来的治疗方案的改变；再以CT图像和PET／CT融合图像分别勾画靶区，对两者进行比较。结果PET／CT使18例（50．O％，18／36）患者的临床分期发生改变。11例（30．6％，11／36）因PET／CT发现远处转移，临床分期升为Ⅳ期，从而更改了治疗方案，其中3例由根治性放疗改为姑息性放疗，7例由放疗改为化疗，1例转为最佳支持治疗。25例行根治性3D—CRT的患者中，21例放疗靶区均有不同程度改变，其中靶区增大7例，减小12例，靶区位置移动2例；3例患者在3D—CRT的基础上增加锁骨上区常规放疗。3例姑息性放疗患者中，2例靶区减小，1例靶区增大。结论PET／CT通过提高合并肺不张的NSCLC临床分期的准确性，辅助制定更加合理的治疗方案；通过有效检测出区域转移灶和转移淋巴结，降低靶区遗漏的可能；
Objective To investigate the impact of PET/CT on the treatment planning and target volume delineation of radiotherapy in patients with NSCLC complicated by atelectasis. Methods Pre-treat- ment PET/CT scans were performed in 36 patients with pathologically proven NSCLC complicated by atelec- tasis of different severity undergoing curative 3D-CRT planning. Clinical staging before and after PET/CT was compared and the change of treatment plan was evaluated. The target volumes were delineated by CT and PET/CT. Results PET/CT results changed the clinical staging in 18 （50.0%, 18/36） patients. PET/CT identified distant metastatic diseases in 11 （30.6%, 11/36） patients, thus excluding their eligi- bility for curative 3D-CRT. Of these 11 patients, managements were changed to palliative radiotherapy in 3 patients, chemotherapy in 7 patients and best supportive therapy in 1 patient. In the 25 patients with cura- tive 3D-CRT, PET/CT altered the radiotherapy volume in 21 cases, including 12 with volume reduction, 7 with volume enlargement and 2 with location change. Three patients were given additional conventional ra- diotherapy, since PET/CT indicated supraclavicular nodal metastases. In the 3 patients with palliative 3D- CRT, 2 had target volume reduction and 1 had target volume enlargement after PET/CT. Conclusions PET/CT may play a role in the management of patients with NSCLC complicated by atelectasis. It is also helpful for accurate delineation of target volume in 3D-CRT treatment planning.
出处
《中华核医学与分子影像杂志》
CSCD
北大核心
2012年第2期115-118,共4页
Chinese Journal of Nuclear Medicine and Molecular Imaging
基金
辽宁省科学技术计划项目（2006225007-5）
