论文部分内容阅读
目的观察非小细胞肺癌(non-small cell lung cancer,NSCLC)患者放疗前、后~(99)Tc~m-HL91乏氧显像与~(18)F-FDG符合线路正电子显像变化,探讨2种方法评价NSCLC放疗疗效的价值。方法 NSCLC患者20例,均行三维适形放疗,分别于放疗前1周、放疗结束后8周行18F-FDG符合线路正电子显像、静脉注射~(99)Tc~m-HL91后4h平面及SPECT/CT断层显像,采用半定量法测量肿瘤病灶和对侧正常肺组织摄取~(18)F-FDG及~(99)Tc~m-HL91比值(T/N);依据放疗疗效将20例患者分为放疗有效组和无效组,观察2组放疗前、后T/N比值变化,分析其与放疗疗效的关系。结果放疗后病灶和对侧正常肺组织摄取18F-FDG T/N比值(5.47±1.69)较放疗前(7.51±1.53)降低(P<0.05);放疗后病灶和对侧正常肺组织摄取~(99)Tc~m-HL91的4h平面及SPECT/CT断层显像T/N比值(1.20±0.11、1.61±0.27)较放疗前(1.44±0.08、1.98±0.21)降低(P<0.05);放疗前后摄取~(99)Tc~m-HL91的4h平面及SPECT/CT断层显像T/N比值明显低于摄取~(18)F-FDG T/N比值(P<0.05);放疗结束后8周评价放疗疗效,有效13例,无效6例,死亡1例;放疗有效组、无效组放疗后病灶与对侧正常肺组织摄取~(99)Tc~m-HL91的4h断层显像T/N比值(1.34±0.13、1.82±0.35)低于放疗前(1.69±0.21、2.04±0.32)(P<0.05),且2组放疗前后T/N比值比较差异有统计学意义(P<0.05);有效组治疗前~(18)F-FDG显像T/N比值(7.34±1.25)与无效组(7.58±1.62)比较差异无统计学意义(P>0.05),放疗后有效组T/N比值(4.61±1.32)较放疗前降低,且低于无效组放疗后(7.23±1.34)(P<0.05);病灶摄取~(18)F-FDG和~(99)Tc~m-HL91 4h断层显像的T/N比值呈直线相关(r=0.641,P=0.034)。结论放疗可有效降低肿瘤的乏氧水平和肿瘤的葡萄糖代谢活性;~(99)Tc~m-HL91显像可反映病灶的乏氧状态及放疗前后乏氧水平改善程度,初步评价放疗疗效。
Objective To observe the changes of 99m Tc-m-HL91 hypoxic imaging and 18F-FDG coincidence line positron emission tomography before and after radiotherapy in patients with non-small cell lung cancer (NSCLC) To evaluate the value of two methods in evaluating the efficacy of radiotherapy for NSCLC. Methods Twenty patients with NSCLC were treated with three-dimensional conformal radiotherapy. One week before radiotherapy and 18F-FDG coincidence positron emission tomography were performed 8 weeks after radiotherapy. Intravenous injection of ~ (99) Tc ~ m-HL91 4h plane (18) F-FDG and 99 Tc-m-HL91 ratio (T / N) were measured by semi-quantitative method in both tumor and contralateral normal lung tissues. Twenty patients were divided into radiotherapy effective group and ineffective group. The changes of T / N ratio before and after radiotherapy were observed in two groups, and the relationship between radiotherapy and radiotherapy was analyzed. Results The T / N ratio of 18F-FDG uptake (5.47 ± 1.69) in lesion and contralateral normal lung tissue after radiotherapy was significantly lower than that before radiotherapy (7.51 ± 1.53) (P <0.05) The T / N ratios (1.20 ± 0.11,1.61 ± 0.27) in 4 h plane and SPECT / CT imaging of Tc m-HL91 were significantly lower than those before radiotherapy (1.44 ± 0.08 and 1.98 ± 0.21, respectively; P <0.05) The ratio of T / N in 4h plane and SPECT / CT imaging before and after uptake of ~ (99) Tc ~ m-HL91 was significantly lower than that of 18 F-FDG uptake (P <0.05) Weekly evaluation of radiotherapy efficacy, 13 cases were effective, 6 cases were ineffective, and 1 case died; radiotherapy effective group, invalid group after radiotherapy lesions and contralateral normal lung tissue uptake 99Tc ~ m-HL91 4h tomography T / N (1.34 ± 0.13, 1.82 ± 0.35) were lower than those before radiotherapy (1.69 ± 0.21, 2.04 ± 0.32) (P <0.05), and the T / N ratio of the two groups before and after radiotherapy had statistical significance (P <0.05). The T / N ratio of ~ (18) F-FDG imaging before treatment in the effective group (7.34 ± 1.25) was significantly lower than that in the inactive group (7.58 ± 1.62) (P> 0.05) (4.61 ± 1.32) were lower than those before radiotherapy, and were lower than those in ineffective group (7.23 ± 1.34) (P <0.05). The uptake of ~ (18) F-FDG and ~ The T / N ratio of c ~ m-HL91 4h imaging showed a linear correlation (r = 0.641, P = 0.034). Conclusions Radiotherapy can effectively reduce the level of hypoxia in tumor and the glucose metabolism activity of tumor. ~ (99) Tc ~ m-HL91 imaging can reflect the hypoxic state of lesions and the degree of hypoxia before and after radiotherapy, and evaluate the curative effect of radiotherapy.