摘要
目的:探讨能谱CT定量参数在评估中晚期食管鳞状细胞癌(ESCC)放疗早期疗效中的价值。方法:选取2018年7月—2020年6月徐州市肿瘤医院行能谱CT检查的87例中晚期ESCC患者作为研究对象,测量放疗前后癌灶的能谱定量参数值,计算放疗前后定量参数的变化、能谱曲线斜率,根据RECIST 1.1版标准分为有效组69例和无效组18例,比较以上碘值、能谱曲线斜率在两组患者间的差异,将放疗前两组间存在统计学差异的参数进行logistic回归分析,找出对预测早期疗效有价值的参数,进入回归方程生成新变量,采用ROC曲线分析新变量及进入方程参数预测放疗疗效的效能。结果:放疗前有效组动脉期碘含量中位数:17.30(11.17~19.71)、静脉期碘含量:(18.31±2.01)及动脉期标准化碘含量(NICAP):0.36(0.23~0.45)、静脉期标准化碘含量(NICVP):0.68(0.54~0.83)及动脉期、静脉期能谱曲线斜率(λAP、λVP):1.82(1.53~2.15)、2.01(1.59~2.35)均高于无效组13.89(11.03~18.26)、15.48±2.61、0.28(0.20~0.39)、0.59(0.50~0.72)、1.73(1.50~1.92)、1.75(1.57~2.12),差异均有统计学意义(Z=-3.568、-3.568、-3.180、-2.265、-3.382;t=4.984,P<0.05);放疗后动脉期、静脉期碘含量较放疗前均减低,但有效组[动脉期碘含量变化率:-29.270(-40.000~0.000)、静脉期碘含量变化率:-24.690(-28.000~-4.670)]较无效组[-19.960(-34.210~-5.710)、-18.755(-27.640~-5.480)]变化更明显,差异有统计学意义(Z=-2.049、-2.447,P<0.05)。放疗前NICVP、λVP进入回归方程,放疗前NICVP、λVP、新变量AUC(ROC曲线下面积)分别为0.728、0.774、0.786,两两比较,差异无统计学意义(P>0.05)。结论:放疗前CT碘成像定量参数可预测中晚期ESCC放疗早期疗效,放疗前NICVP和λVP值越高,放疗有效的可能性越大。
Objective:To investigate the value of quantitative energy-spectrum CT parameters in assessing the early efficacy of radiotherapy for intermediate-stage esophageal squamous cell carcinoma(ESCC).Methods:Patients with intermediate to advanced ESCC who were hospital pre-existing and physically tolerant to radiotherapy and to energy-spectrum CT for 3 months before and after radiotherapy from July 2018 to June 2020 were selected.The values of quantitative parameters of energy spectrum of cancer foci before and after radiotherapy were measured,and the changes of quantitative parameters and slope of energy spectrum curve before and after radiotherapy were calculated.Patients were divided into the effective group and ineffective group according to RECIST version 1.1 criteria,and the above iodine values and slope of energy spectrum curves were compared between the two groups.Parameters that were statistically different between the two groups before radiotherapy were subjected to logistic regression analysis to identify parameters that were valuable in predicting early outcome.New variables were generated by entering the regression equa⁃tion,and ROC curves were used to analyze the efficacy of the new variables and the parameters entering the equation to predict the efficacy of radiotherapy.Results:87 cases of mid-to late-stage ESCC were enrolled,aged(63.92±6.36)years,of which 61 were male and 69 were in the effective group.The median iodine content in the arterial phase(11.17~19.71),intravenous phase(18.31±2.01),standardized iodine content in the arterial phase(NICAP)0.36(0.23-0.45),standardized iodine content in the intrave⁃nous phase(NICVP)0.68(0.54-0.83)and the energy spectrum curves in the arterial and intravenous phases(λAP,λVP)of the ef⁃fective group before radiotherapy were 1.82(1.53-2.15),2.01(1.59-2.35),were higher than those of the null group 13.89(11.03-18.26),(15.48±2.61),0.28(0.20-0.39),0.59(0.50-0.72),1.73(1.50-1.92),1.73(1.50-1.92),and 1.75(1.57-2.12),with sta⁃tistically significant differences(Z
作者
宋勤红
刘彩云
刘庆富
段新
拾博
杨洪义
王强
SONG Qin-hong;LIU Cai-yun;LIU Qing-fu(Department of Radiolo-gy,Huishan District Traditional Chinese Medicine Hospital,Wuxi,Jiangsu,214100,China)
出处
《黑龙江医学》
2023年第7期814-818,共5页
Heilongjiang Medical Journal
基金
徐州市科技局重点研发课题(KC18200)
江苏大学课题(JLY20180119)。
关键词
食管鳞状细胞癌
能谱成像
放疗疗效
Esophageal squamous cell carcinoma
Energy spectrum imaging
Radiotherapy efficacy
