摘要
背景与目的:18F-FLT是一种细胞增殖的示踪剂。探索18F-FLT PET/CT对食管鳞癌根治性放(化)疗效果的预测价值。方法:对根治性放(化)疗的初治食管鳞癌患者,放疗前及放疗第4周行18F-FLT PET/CT扫描,记录原发灶的SUVmax-T、转移淋巴结的SUVmax-N等参数。随访患者总生存期(overall survival,OS)及无进展生存期(progressionfree survival,PFS),分析PET/CT参数与患者预后的关系。结果:共入组39例患者,25例完成2次PET/CT扫描。18F-FLT的SUVmax-T由基线6.63下降到1.22,淋巴结SUVmax-N由3.69下降到1.84,但下比例与生存率无关。18F-FLT PET/CT的基线SUVmax-N<5.00的患者,其OS明显高于SUVmax-N≥5.00的患者(P=0.002)。结论:对根治性放(化)疗食管鳞癌,治疗前的基线18F-FLT PET/CT的淋巴结SUVmax-N是一个较好的预测预后参数。放疗4周时,病灶在18F-FLT PET/CT扫描中的SUV值明显下降,但不能预测预后。
Background and purpose:18F-FLT is a proliferative radiotracer.This study aimed to evaluate the prognostic value of functional molecular image of 18F-FLT PET/CT taken before and in the process of radiotherapy.Methods:Patients with newly diagnosed esophageal squamous cell carcinoma(ESCC)were enrolled in the study.All patients received radiotherapy/chemoradiotherapy.The planned dose was 61.2 Gy and 1.8 Gy per fraction respectively.The concurrent chemotherapy was platinum,paclitaxel or fluoropyrimidine based.Patients were examined by PET with 18F-fluoro-30-deoxy-30-L-fluorothymidine(FLT)at baseline and 4 weeks after treatment initiation.The overall survival(OS)and progression-free survival(PFS)were followed up.The SUV maximum(SUVmax)of primary tumor and positive nodes were recorded.PET/CT findings were analyzed for the correlation with clinical response of patients and survival.Results:Thirty-nine patients were enrolled in the study,among whom 25 patients completed two planned PET/CT.Patients with SUVmax-N≥5.00 had worse OS(P=0.002)and PFS(P=0.01)than those with SUVmax-N<5.00.The SUVmax of both primary tumor and lymph nodes significantly decreased in the interim scan compared to the baseline scan in FLT PET/CT,but the relationship between the change of SUVmax and prognosis seemed to be weak.Conclusion:Baseline SUVmax of lymph node on 18F-FLT PET/CT had prognostic value in patients with esophageal cancer undergoing radiotherapy/radiochemotherapy.The decrease of SUVmax of tumor after 4 weeks’radiotherapy couldn’t predict prognosis properly.
作者
任文佳
周敏
吴式琇
陈俊强
陈亚楠
陈维维
艾沓杉
陈贇
蒋国梁
赵快乐
REN Wenjia;ZHOU Min;WU Shixiu;CHEN Junqiang;CHEN Yanan;CHEN Weiwei;AI Tashan;CHEN Yun;JIANG Guoliang;ZHAO Kuaile(Department of Radiation Oncology,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China;Department of Nuclear Medicine,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China;Department of Radiation Oncology,Shenzhen Hospital of Cancer Hospital of Chinese Academy of Medical Sciences,Shenzhen 518117,Guangdong Province,China;Department of Radiation Oncology,Fujian Cancer Hospital,Fuzhou 350014,Fujian Province,China;Department of Radiation Oncology,Zhangjiagang 1st People’s Hospital,Zhangjiagang Hospital Affiliated to Soochow University,Zhangjiagang 215600,Jiangsu Province,China;Department of Radiation Oncology,the 6th Hospital Affiliated to Nantong University,the Affiliated Hospital of Southeast University,Yancheng 224001,Jiangsu Province,China)
出处
《中国癌症杂志》
CAS
CSCD
北大核心
2019年第12期965-970,共6页
China Oncology
基金
卫生部部属医院临床学科重点项目（基于肿瘤和正常组织生物信息的个体化放疗研究）
