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1、肿瘤防治杂志2005年2月第12卷第3期CHINJCANCERPREVTREAT,February2005,Vol.12No.3·233·×综述·讲座ØPET对非小细胞肺癌三维适形放疗计划的影响121巩合义,周慧,于金明1.山东省肿瘤医院放疗科,山东济南2501172.山东省立医院,山东济南250021Impactofpositronemissiontomographyon32dimensionalconformalradiationtherapyplanningofnon2smallcelllungcancer121GONGHe2y
2、i,ZHOUHui,YUJin2ming1.DepartmentofRadiationOncology,ShandongTumorHospital,Jinan250117,P.R.China2.ShandongProvincialHospital,Jinan250021,P.R.China【摘要】正电子发射计算机断层显像(posi2[ABSTRACT]Asanadvancedfunctionalimaging,throughinflu2tronemissiontomography,PET)作为一种先encingclinicalstag
3、ingofnon2smallcelllungcancer,positronemis2进的功能影像技术,通过影响非小细胞肺癌siontomography(PET)hasanimportantimpactontheestablish2(non2smallcelllungcancer,NSCLC)的临床mentandimplementofits32dimensionalconformalradiationthera2分期,而影响其三维适形放疗(32dimensionalpyplanning.Inpatientswithatelectasis
4、,obstructivepneunonitis,conformalradiationtherapy,3D2CRT)计划的pleuraleffusion,andthoracicextravasate,targetvolumedefinition制定与实施。对于伴阻塞性肺炎、肺不张、胸withCTissomewhatdifficult.However,PETcandistinguish膜受侵和胸腔积液者,CT确定肿瘤边界有一tumortissuefromnormaltissueandsocanhelptoundergoTstage定困难,
5、但PET却能较好地鉴别肿瘤组织与moreaccurately.PETcanreduceirradiatedvolumesignificantly正常组织,因而能更精确地进行T分期并可andsounnecessaryirradiationofnormaltissuecanbeavoided.For明显缩小照射野,减少正常组织受量;对于受tumorsaffectedmuchbyrespiratorymovementandheartbeat,呼吸运动、心脏搏动影响较大的肿瘤,PET能PETcanoffermoreaccurate32dime
6、nsionalsimulativeimagethan提供精确的三维模拟图象,从而能据以制定CTandcanperformindividualradiationtreatmentplanning.The出个体化的放疗计划。PET检测纵隔淋巴sensitivityofPETindetectingmediastinallymphnodeishigher结的敏感性比CT高,对直径≤1cm的淋巴thanCT,especiallyforthatwhosediameterisequalorlargerthan结的检出率尤其高,从而可发现CT阴性的1
7、cm.SoPETcandetectinvolvedlymphnodethatisnegativeon转移淋巴结,也可排除CT阳性的正常淋巴CTwhilecanconfirmnormallymphnodethatispositiveonCT.结而修正常规的N分期。PET诊断远处转Therefore,PETcanmodifyconventionalNstage.PEThasmore移的优势也比其他影像学手段明显,尤其对distinctpredominanceindiagnosingmetastasisthanotherimagingⅢ期患
8、者更为有益。PET可改变20%～approaches,especiallyforthosewhoareStagedⅢconventionally.30%NSCLC患者的整体治疗策略,使不同的PETcanchangethe
