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目的利用99mTc-HL91乏氧显像探讨鼻咽癌(NPC)三维适形放疗(3DCRT)前、后乏氧程度及乏氧变化与放疗疗效的相关性。方法38例NPC患者在3DCRT前、后按常规进行鼻咽、颈部99mTc-HL91断层显像;并对病灶的靶/非靶(T/N)值进行半定量分析。结果38例NPC患者中有32例NPC病灶乏氧检查阳性,阳性率约为84%。32例患者鼻咽病灶与正常鼻咽组织乏氧程度(T/N)值分别为1.89±0.95、1.06±0.18,P<0.001,两者存在显著性差异。32例NPC患者在放疗前、后NPC乏氧病灶的T/N均值比较,P<0.001,有显著性差异;鼻咽病灶乏氧状态对放射治疗的响应呈正相关,相关系数为0.641,P<0.01;38例NPC患者在3DCRT放疗后近期疗效显著,肿瘤局部控制率较高,急性放射损伤并发症较少,患者生活质量得到改善。结论99mTc-HL91乏氧显像可检测NPC病灶的乏氧状态;鼻咽癌病灶乏氧状态与3DCRT的放疗疗效密切相关。
Objective To investigate the relationship between the degree of hypoxia before and after nasopharyngeal carcinoma (NPC) three-dimensional conformal radiotherapy (NPC) and the effect of hypoxia on radiotherapy with 99mTc-HL91 hypoxia imaging. Methods Thirty-eight NPC patients underwent nasopharyngeal and cervical 99mTc-HL91 imaging before and after 3DCRT. The target / non-target (T / N) values of the lesions were semi-quantitatively analyzed. Results Thirty-two NPC patients had hypoxia test in 32 cases, the positive rate was about 84%. The hypoxia (T / N) values of nasopharyngeal lesions and normal nasopharyngeal tissues of 32 patients were 1.89 ± 0.95 and 1.06 ± 0.18, respectively, P <0.001, there were significant differences between the two groups. The 32 patients with NPC had significant differences in T / N mean value of hypoxia before and after radiotherapy (P <0.001, P <0.001). The response of nasopharyngeal hypoxia to radiotherapy was positively correlated with a correlation coefficient of 0.641 (P < 0.01; 38 cases of NPC patients in the short term after 3DCRT radiotherapy significant effect of local tumor control rate higher, less acute radiation injury complications, patients with improved quality of life. Conclusion 99mTc-HL91 hypoxia imaging can detect the hypoxic state of NPC lesions. The hypoxic state of NPC lesions is closely related to the radiotherapy effect of 3DCRT.