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目的18F-FDG-PET能否早期监测放疗疗效目前仍有争议,放射治疗后何时行18F-FDG-PET检查既能评价放疗响应又能排除放疗引起放射性炎症对检查结果的影响,仍没有统一标准。本研究旨在研究18F-FDG-PET对评价鼻咽鳞癌早期放疗响应的临床价值。方法自2009年3月至2009年11月,我院入组的32例确诊的初治鼻咽鳞癌患者,所有患者在治疗前一周和放疗中(DT50Gy/25F,5W)及放疗结束(DT70Gy/25F,7W)后1周内分别行18F-FDG-PET/CT检查,分别计算相关指标。结果32例患者中与放疗前相比,放疗中及放疗结束一周内SUVmax均明显下降,治疗前(单纯放疗或放化疗同步治疗)原发病灶SUVmax值平均值为(12.1±5.51)(2.70～24.5),放中SUVmax值平均值为(3.69±1.97)(1.3～7.60),放疗结束一周内SUVmax值平均值为(3.06±1.63)(1.20～7.50)。三组数据均提示放疗过程中18F-FDG最大标准摄取值(SUVmax)逐步降低(P<0.001)。结论18F-FDG-PET可能能够早期监测鼻咽癌放疗响应,有利于决定下一步治疗方案,作为设计放疗总剂量或综合应用手术、化疗提供一些依据。
Objective 18F-FDG-PET early monitoring of radiotherapy is still controversial, when the line after radiotherapy by 18F-FDG-PET examination can not only evaluate the radiotherapy response but also to exclude radiation-induced radiological inflammation on the test results, there is no uniform standard. The aim of this study was to investigate the clinical value of 18F-FDG-PET in evaluating early radiotherapy response to nasopharyngeal squamous cell carcinoma. Methods From March 2009 to November 2009, 32 newly diagnosed patients with nasopharyngeal squamous cell carcinoma were enrolled in our hospital. All patients underwent radiotherapy (DT50Gy / 25F, 5W) and DT70Gy / 25F, 7W) within 1 week after the line of 18F-FDG-PET / CT examination, respectively, to calculate the relevant indicators. Results Compared with those before radiotherapy, the SUVmax of the 32 patients before radiotherapy and within one week after the end of radiotherapy were significantly decreased. The average value of SUVmax before treatment (synchronous radiotherapy or radiotherapy and chemotherapy alone) was (12.1 ± 5.51) (2.70 ~ 24.5). The mean value of SUVmax was (3.69 ± 1.97) (1.3 ~ 7.60). The average value of SUVmax within one week after the end of radiotherapy was (3.06 ± 1.63) (1.20 ~ 7.50). All three data suggest that the 18 F-FDG maximal standard uptake value (SUVmax) decreased gradually during radiotherapy (P <0.001). Conclusion 18F-FDG-PET may be able to monitor the radiotherapy response of nasopharyngeal carcinoma in the early stage, which is helpful to decide the next treatment plan and provide some basis for designing the total dose of radiotherapy or the combination of operation and chemotherapy.