摘要
目的探讨局部晚期喉原发鳞状细胞癌(简称喉鳞癌)在以顺铂为基础的放化疗联合治疗过程中灌注参数的变化及CT灌注成像(CTPI)在预测联合放化疗疗效中的价值。方法对29例局部晚期喉鳞癌患者,在治疗前以及放疗剂量达40 Gy、70 Gy时分别进行CTPI,并测量肿瘤的血流量(BF)、血容量(BV)、平均通过时间(MTT)、表面通透性(PS)。根据第3次检查时的肿瘤体积减小的百分率分为敏感组及不敏感组,并对肿瘤各项灌注参数值进行对比,采用ROC曲线分析对基础(治疗前)及治疗期间灌注参数在肿瘤对治疗方案敏感性方面的预测价值进行评价。结果在敏感组,放疗剂量达40 Gy、70 Gy时,灌注参数BF明显下降(P=0.04和0.01);放疗剂量为40 Gy时灌注参数BV明显下降(P=0.04),70 Gy时减低更加明显(P=0.01);肿瘤基础BV在预测肿瘤对治疗方案敏感性方面的特异度和敏感度分别为100%和83.00%;40 Gy以后,灌注参数BV的预测价值高于BF和MTT。结论 CT灌注成像在明确局部晚期喉鳞癌对以顺珀为基础的放化疗联合治疗方案的敏感性方面有预测价值。
Objective To observe the changes of perfusion parameters in advanced primary laryngeal squamous cell carcinoma（SCC） during concomitant cisplatin-based chemoradiotherapy,and to investigate the predictive value of CT perfusion imaging（CTPI） for response of the tumor to therapy.Methods Totally 29 patients with locoregionally advanced primary laryngeal SCC underwent CTPI before therapy and after completion of 40 Gy and 70 Gy of chemoradiotherapy.Blood flow（BF）,blood volume（BV）,mean transit time（MTT）,permeability surface（PS） of the primary tumors were quantified.All patients were divided into responder group and non-responder group according to the third examine result,and perfusion parameters were compared between the two groups.ROC curves were used to assess the predictive value of parameters of baseline and treatment periods for the sensibility of treatment plan.Results In responder group,BF values decreased under the radiotherapy dosage of 40 Gy and 70 Gy compared with the baseline values（P=0.04,0.01）;BV values decreased under the radiotherapy dosage of 40 Gy（P=0.04） and reduced more obvious under 70 Gy（P=0.01）.The specificity and sensitivity of baseline BV predicting tumor response was 100% and 83.00%,respectively.The predictive value of BV was higher than that of BF and MTT after completion of 40 Gy.Conclusion CTPI has predictive value of identifying tumors responding to cisplatin-based chemoradiotherapy in patients with advanced laryngeal squamous cell carcinoma.
出处
《中国医学影像技术》
CSCD
北大核心
2011年第8期1563-1567,共5页
Chinese Journal of Medical Imaging Technology
关键词
灌注成像
体层摄影术
X线计算机
喉癌
癌
鳞状细胞
Perfusion imaging
Tomography
X-ray computed
Laryngeal carcinoma
Carcinoma
squamous cell
