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1、腫瘤防治雜志2005年2月第12卷第3期CHINJCANCERPREVTREAT,February2005,Vol.12No.3·233·×綜述·講座?PET對非小細(xì)胞肺癌三維適形放療計(jì)劃的影響121鞏合義,周慧,于金明1.山東省腫瘤醫(yī)院放療科,山東濟(jì)南2501172.山東省立醫(yī)院,山東濟(jì)南250021Impactofpositronemissiontomographyon32dimensionalconformalradiationtherapyplanningofnon2smallcelllungcancer121GONGHe2y
2、i,ZHOUHui,YUJin2ming1.DepartmentofRadiationOncology,ShandongTumorHospital,Jinan250117,P.R.China2.ShandongProvincialHospital,Jinan250021,P.R.China【摘要】正電子發(fā)射計(jì)算機(jī)斷層顯像(posi2[ABSTRACT]Asanadvancedfunctionalimaging,throughinflu2tronemissiontomography,PET)作為一種先encingclinicalstag
3、ingofnon2smallcelllungcancer,positronemis2進(jìn)的功能影像技術(shù),通過影響非小細(xì)胞肺癌siontomography(PET)hasanimportantimpactontheestablish2(non2smallcelllungcancer,NSCLC)的臨床mentandimplementofits32dimensionalconformalradiationthera2分期,而影響其三維適形放療(32dimensionalpyplanning.Inpatientswithatelectasis
4、,obstructivepneunonitis,conformalradiationtherapy,3D2CRT)計(jì)劃的pleuraleffusion,andthoracicextravasate,targetvolumedefinition制定與實(shí)施。對于伴阻塞性肺炎、肺不張、胸withCTissomewhatdifficult.However,PETcandistinguish膜受侵和胸腔積液者,CT確定腫瘤邊界有一tumortissuefromnormaltissueandsocanhelptoundergoTstage定困難,
5、但PET卻能較好地鑒別腫瘤組織與moreaccurately.PETcanreduceirradiatedvolumesignificantly正常組織,因而能更精確地進(jìn)行T分期并可andsounnecessaryirradiationofnormaltissuecanbeavoided.For明顯縮小照射野,減少正常組織受量;對于受tumorsaffectedmuchbyrespiratorymovementandheartbeat,呼吸運(yùn)動、心臟搏動影響較大的腫瘤,PET能PETcanoffermoreaccurate32dime
6、nsionalsimulativeimagethan提供精確的三維模擬圖象,從而能據(jù)以制定CTandcanperformindividualradiationtreatmentplanning.The出個體化的放療計(jì)劃。PET檢測縱隔淋巴sensitivityofPETindetectingmediastinallymphnodeishigher結(jié)的敏感性比CT高,對直徑≤1cm的淋巴thanCT,especiallyforthatwhosediameterisequalorlargerthan結(jié)的檢出率尤其高,從而可發(fā)現(xiàn)CT陰性的1
7、cm.SoPETcandetectinvolvedlymphnodethatisnegativeon轉(zhuǎn)移淋巴結(jié),也可排除CT陽性的正常淋巴CTwhilecanconfirmnormallymphnodethatispositiveonCT.結(jié)而修正常規(guī)的N分期。PET診斷遠(yuǎn)處轉(zhuǎn)Therefore,PETcanmodifyconventionalNstage.PEThasmore移的優(yōu)勢也比其他影像學(xué)手段明顯,尤其對distinctpredominanceindiagnosingmetastasisthanotherimagingⅢ期患
8、者更為有益。PET可改變20%～approaches,especiallyforthosewhoareStagedⅢconventionally.30%NSCLC患者的整體治療策略,使不同的PETcanchangethe
