论文部分内容阅读
目的 探讨正电子核素18F标记的氟脱氧葡萄糖正电子发射断层扫描(18F-FDG PET/CT)对中晚期胃癌患者疗效和预后的临床评估价值.方法 将35例中晚期胃癌患者根据病史分为单纯化疗(CT)组23例和同步放化疗(CCRT)组12例,分别于治疗前、治疗第3~4周和治疗后1~3个月行18F-FDG PET/CT检查,比较其最大标准摄取值(SUVmax)和代谢肿瘤体积(MTV)与治疗前的变化百分比(ΔSUVmax%和ΔMTV%).在CCRT组和CT组中,以ΔSUVmax%降低≥43.08%作为阈值将每组分为两个亚组,采用受试者工作特征(ROC)曲线评价代谢参数的敏感性和特异性,分析总生存期(OS)和无进展生存期(PFS)的影响因素.结果 胃腺癌原发病灶的平均SUVmax随着治疗时间的延长逐渐降低.CT组和CCRT组的总缓解率(34.8%比50.0%,P=0.383)、疾病控制率(73.9%比75.0%,P=0.944)比较,差异无统计学意义;两组OS和PFS比较差异均无统计学意义(P>0.05).CT组治疗后 SUVmax及 MTV越低,则 OS、PFS越长(P 0.05).结论 行CT和CCRT治疗的ΔSUVmax%降低≥43.08%的中晚期胃癌患者OS和FPS均较长,提示预后更佳.18F-FDG PET/CT对评估中晚期胃癌治疗效果及预后具有应用价值.“,”Objective To investigate theprognostic evaluation and therapeutic effect assessed by 18 F-FDG PET/CT for advanced gastric cancer. Methods A total of 35 patients with advanced gastric cancer were divided into two groups,23 patients in chemotherapy(CT)group and 12 patients in concurrent chemoradiation therapy(CCRT)group according to case history. 18F-FDG PET/CT images for each patient were acquired at pre-treatment,during-treatment at 3-4 weeks,and 1-3 months post-treatment.The percentage changes in the maximum values of standardized uptake value(ΔSUVmax%)and metabolic tumour volume(ΔMTV%)from the PET/CT images were compared.Each group was classified as two sub-group by a decrease of ≥43.08% of ΔSUVmax% between pre-treatment and post-treatment PET/CT.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the specificity and sensitivity of each metabolic parameter.Affecting factors of progression-free survival(PFS)and overall survival(OS)were analyzed. Results Mean SUVmaxfor primary tumor of gastric adenocarcinoma decreased gradually with the prolongation of treatment time.No significant difference between CT group and CCRT group were observed for overall response rate(ORR,34.8% vs 50.0%,P=0.383)and disease control rate(DCR,73.9% vs 75.0%,P=0.944).There was no significant difference in OS and PFS between two groups(P>0.05).For CT group,when the SUVmaxand MTV were lower after treatment,OS and PFS were longer,while all clinical factors including SUVmaxchange rate were not correlated with OS and PFS in CCRT group(P>0.05).Conclusion OS and FPS in patients with advanced gastric cancer and a decrease of ΔSUVmax%≥43.08% who receive CT and CCRT are longer which suggests that the prognosis is better. 18F-FDG PET/CT is of great significance to evaluating the therapeutic effect and prognosis of advanced gastric cancer.