PETCT对非小细胞肺癌分期和放疗计划影响.docVIP

PETCT对非小细胞肺癌分期和放疗计划影响 　　【摘要】 目的：比较非小细胞肺癌患者分别依据CT和PET/CT制定的放疗计划，以及PET/CT对分期的影响，同时观察不同放疗医师勾画靶区的差异。方法：20例行调强适行放疗的非小细胞肺癌患者均进行PET/CT检查，并分别在CT和PET/CT融合图像下行TNM分期和设计放疗计划。比较两个计划GTV的大小和危及器官受到的剂量。同时组织三位放疗医师分别在CT和PET/CT图像上勾画靶区，比较勾画靶区的差异。结果：40.0%（8/20）的患者TNM分期发生改变，45.0%（9/20）患者GTV发生了改变，CT下勾画靶区GTV明显高于PET/CT下勾画靶区GTV（P0.05）。结论：PET/CT可改变临床分期，降低肿瘤靶区体积，从而可以更好地保护周围正常组织和器官，并能明显减少不同放疗科医师勾画靶区的差异。 　　【关键词】 非小细胞肺癌； PET/CT； 大体肿瘤靶区； 适形调强放疗 　　【Abstract】 Objective：To compare radiotherapy plans made according to CT and PET/CT and to investigate the impact of on the staging in non-small cell lung cancer（NSCLC） and the variation in delineating gross tumor volumes（GTVs）in different radiation oncologists was also observed.Method：All twenty patients with NSCLC who were candidates for intensity-modulated radiotherapy （IMRT） underwent planning PET/CT examination. PET/CT and CT were applied on delineation of target volumes and formulation of radiotherapy plans respectively and the clinical staging，the size of GTV and the exposure of organs at risk （OAR） were compared.The variation in delineating tumor volumes was assessed by three radiation oncologists.Result：Changes in tumor-node-metastasis categories occurred in 40.0%（8/20） and alterations in GTV occurred in 45.0%（9/20） atients ased on PET/CT.PET/CT information led to a significant decrease in the sizes of GTV and the radiation exposure of lung， heart， esophagus and the spinal cord in comparison with CT targeting（P0.05）.Conclusion：PET/CT fusion images have a potential impact on tumor staging and lead to a significant decrease in the sizes of target volumes， which have the impact on the radiation exposure of OARs and reduce variation in delineating tumor volumes significantly among different radiation oncologists. 　　【Key words】 Non-small cell lung cancer； PET/CT； Gross tumor volume； Intensity-modulated radiotherapy 　　First-author’s address：Yangzhou University Clinical College Subei People’s Hospital，Yangzhou 225001，China 　　doi：10.3969/j.issn.1674