Radiother Oncol：FDG-PET可评估局部晚期非小细胞肺癌同步放化疗后放疗剂量和急性食管炎的关系
2013-05-06 echo1166 互联网
为了通过FDG-PET确定放化疗后的晚期局部非小细胞肺癌患者所接受的放疗剂量和急性食管炎之间的联系。Jasper Nijkamp等为了回答上述问题，进行了相关研究，其研究结果发表在Radiother Oncol 12月最新的在线期刊上。 研究者纳入的患者为接受24*2.75Gy、在完成放化疗后3个月内进行过放疗后PET检查。PETpost与2级以下和大于等于2级急性食管炎之间的联系的PET评价价
为了通过FDG-PET确定放化疗后的晚期局部非小细胞肺癌患者所接受的放疗剂量和急性食管炎之间的联系。Jasper Nijkamp等为了回答上述问题，进行了相关研究，其研究结果发表在Radiother Oncol 12月最新的在线期刊上。
研究者纳入的患者为接受24*2.75Gy、在完成放化疗后3个月内进行过放疗后PET检查。PETpost与2级以下和大于等于2级急性食管炎之间的联系的PET评价价值通过最高50%食管SUV评价。食管壁的局部剂量与SUV相关，Lyman–Kutcher–Burman (LKB模型用于预测2级以上的急性食管炎。LKB模型中的局部剂量-反应联系用于计算EUD。通过比较Dmean、V35、V55和V60结果评估预测的精确性。
共有82名患者被纳入研究。SUV50%在2级以上的急性食管炎患者中显著增高。LKB参数n=0.130、m=0.25、TD50=50.4%Gy，这提示着与其他预测因素相比，其对急性食管炎发生的预测性更好。
食管在同步放化疗后所摄取的FDG能反映急性食管炎的严重程度。通过使用局部剂量-SUV应答模型能改善对于2级以上食管炎的预测。
DOI:10.1016/j.radonc.2012.09.024,
PMC:
PMID:
Relating acute esophagitis to radiotherapy dose using FDG-PET in concurrent chemo-radiotherapy for locally advanced non-small cell lung cancer
Jasper Nijkamp1, Maddalena Rossi1, Joos Lebesque, Jose Belderbos, Michel van den Heuvel, Margriet Kwint, Wilma Uyterlinde, Wouter Vogel, Jan-Jakob Sonke
Purpose To correlate radiotherapy (RT) dose to acute esophagitis (AE) by means of FDG-PET scans acquired after concurrent chemo-radiotherapy (cCRT) for locally advanced non-small-cell lung cancer (NSCLC). Materials and methods Patients treated with 24 × 2.75 Gy were selected on presence of a post-RT PET (PETpost) scan acquired within 3 months after cCRT. The value of PETpost in relation to AE was evaluated by comparing the mean esophageal SUV of the highest 50% (〈SUV50%〉) between gr < 2 and gr ⩾ 2AE. The local dose on the esophagus wall was correlated to the SUV and modeled using a power-law fit. The Lyman–Kutcher–Burman (LKB) model was used to predict gr ⩾ 2AE. The local dose–response relation was used in the LKB model to calculate the EUD. Resulting prediction accuracy was compared to Dmean, V35, V55 and V60. Results Eighty-two patients were included (gr < 2 = 25, gr ⩾ 2 = 57). The 〈SUV50%〉 was significantly higher for gr ⩾ 2AE (2.2 vs. 2.6, p < 0.01). The LKB parameters (95% CI) were n = 0.130 (0.120–0.141), m = 0.25 (0.13–0.85) and TD50 = 50.4 Gy (37.5–55.4), which resulted in improved predictability of AE compared to other predictors. Conclusion Esophageal uptake of FDG post-cCRT reflects AE severity. Predictability of grade ⩾2AE was improved by using the local dose–SUV response model, with narrow confidence intervals for the optimized LKB parameters.
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#Radiother#
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#非小细胞#
32
#局部晚期#
37
#Oncol#
35
#PE#
40
#放化疗#
31
#PET#
0
#局部#
27
#食管#
26
#食管炎#
22