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目的分析18F-FDG PET/CT在鼻咽癌患者调强放疗计划过程中对肿瘤治疗计划制定的影响。方法首先单独基于PET/CT中的CT进行治疗计划的制定,内容包括治疗方案和肿瘤靶区(GTV)的勾画。之后基于PET/CT再次进行治疗计划的制定,并分析其变化情况,采用体积法和共同靶区/总靶区法对GTV改变情况进行评估。结果基于PET/CT制定计划后21例患者中有3例(14%)分期改变,2例改行化疗为主的综合治疗,19例最终进行调强放疗的患者GTV均发生改变。体积法显示9例(47.4%)患者的GTV得到了缩小,10例(52.6%)得到了扩大。其中6例(31.6%)发生显著改变。共同靶区/总靶区法显示有9例(47.4%)患者的GTV发生显著改变。在复发鼻咽癌患者中的GTV改变比初发患者更明显。随访未发现治疗区域肿瘤残余以及复发患者。结论利用PET/CT将使鼻咽癌患者的分期更精确,有利于制定出更合理的治疗方案,PET/CT影响调强放疗GTV的制定,对复发鼻咽癌患者的影响更明显。
Objective To analyze the influence of 18F-FDG PET / CT on the planning of cancer treatment in the course of IMRT planning for patients with nasopharyngeal carcinoma. Methods The treatment plan was first based solely on the CT in PET / CT and included the outline of the treatment regimen and the tumor target area (GTV). After that, based on PET / CT, the treatment plan was again made and the changes were analyzed. The changes of GTV were evaluated by the volume method and the common target / total target area. Results Based on PET / CT, 3 out of 21 patients (14%) were scheduled for stage change, 2 were treated by combined chemotherapy and chemotherapy, and 19 were treated with IMRT. The volumetric method showed that GTV was reduced in 9 (47.4%) patients and in 10 (52.6%) patients enlarged. Six cases (31.6%) changed significantly. The common target / total target approach showed significant changes in GTV in 9 (47.4%) patients. GTV changes in patients with recurrent nasopharyngeal carcinoma are more pronounced than those in first-time patients. Follow-up did not find the treatment area tumor residual and recurrence patients. Conclusion PET / CT will make the staging of patients with nasopharyngeal carcinoma more accurate and help to make a more reasonable treatment plan. The effect of PET / CT on the development of GTV with IMRT is more obvious for patients with recurrent nasopharyngeal carcinoma.