论文部分内容阅读
目的探讨局限期小细胞肺癌PET-CT定位适形放疗联合化疗的疗效。方法回顾性分析局限期小细胞肺癌58例,其中28例经PET-CT扫描(PET-CT组),30例采用普通CT定位(普通CT组),所有患者均用相同剂量适形放疗联合EP方案化疗,观察两组患者的疗效、不良反应及失败原因。结果 PET-CT组的平均GTV与PTV体积均小于普通CT组,PET-CT组的左肺与右肺V20、心脏、食管与脊髓V40均小于普通CT组(P<0.05)。两组近期总有效率差异无统计学意义(P>0.05)。PET-CT组中,1、2级肺和气管的早期与晚期放射损伤发生率低于普通CT组(P均<0.05)。PET-CT组的1、2、3年局部控制率和生存率均高于普通CT组(P<0.01)。PET-CT组纵膈淋巴结复发率低于普通CT组,放化疗后手术切除残存病灶者预后好。治疗失败的主要原因为远处转移。结论PET-CT定位可以优化局限期小细胞肺癌的放疗设野计划,减少正常组织的照射体积与纵膈复发率,放化疗后手术切除残存病灶预后好,远处转移为主要失败原因。
Objective To investigate the curative effect of PET-CT localized conformal radiotherapy combined with chemotherapy in localized small cell lung cancer. Methods Fifty-eight patients with SCLC were retrospectively analyzed. Among them, 28 cases were diagnosed by PET-CT and 30 cases were treated by conventional CT. All patients were treated with the same dose of conformal radiotherapy combined with EP Program chemotherapy, observation of two groups of patients efficacy, adverse reactions and failure causes. Results The average volumes of GTV and PTV in PET-CT group were smaller than those in CT group. V20 in left lung and right lung in PET-CT group were lower than those in CT group (P <0.05). There was no significant difference in total effective rate between the two groups (P> 0.05). In the PET-CT group, the incidence of early and late radiation injury in stage 1 and 2 lungs and trachea was lower than that in the normal CT group (all P <0.05). The local control rates and survival rates in PET-CT group at 1, 2 and 3 years were higher than those in normal CT group (P <0.01). The recurrence rate of mediastinal lymph nodes in PET-CT group was lower than that in general CT group. The prognosis was good in residual resection after radiotherapy and chemotherapy. The main reason for treatment failure is distant metastasis. Conclusion The PET-CT localization can optimize the radiotherapy field planning in SCLC and reduce the irradiation volume and the mediastinal recurrence rate in normal tissue. The prognosis of residual resected surgically after radiotherapy and chemotherapy is good, and the distant metastasis is the main cause of failure.