Abramyuk Andrij, Tokalov Sergey, Zöphel Klaus, Koch Arne, Szluha Lazanyi Kornelia, Gillham Charles, Herrmann Thomas, Abolmaali Nasreddin
OncoRay, Center for Radiation Research in Oncology, TU, Dresden, Germany.
Radiother Oncol. 2009 Jun;91(3):399-404. doi: 10.1016/j.radonc.2009.01.003. Epub 2009 Jan 23.
Local failure is a significant issue following radiotherapy (RT) for patients with non-small cell lung cancer (NSCLC). The aim of this study was to find out whether FDG-PET/CT is capable to predict tumor relapse location in patients with NSCLC, in particular to determine high risk tumors' subvolumes responsible for local failure.
Ten patients with locoregional relapse of NSCLC underwent FDG-PET/CT before, during, and in the 4-12 months following curative chemoradiotherapy (ChRT, 66 Gy) using a combined PET/CT scanner. Morphologic and metabolic tumor volumetry and an evaluation of FDG-uptake dynamics were performed.
CT showed partial reduction of tumor volume after RT in all patients. PET-revealed partial in eight patients and complete metabolic response in two patients during RT. Six to nine months after RT, local failure was diagnosed in all patients with both methods. Tumor recurrences were localized mostly in the most active ones of pre-therapeutically metabolic regions of the primary tumor.
Local failure in NSCLC appears most common at the primary site and within the irradiated target volume with the highest FDG uptake. This observation may be useful for further optimization of radiotherapy of NSCLC, for example, by the application of additional radiation dose to subvolumes of primary tumors with higher FDG uptake.
局部复发是影响非小细胞肺癌（NSCLC）患者放疗（RT）疗效的重要因素。本研究旨在探讨FDG-PET/CT能否预测NSCLC患者的肿瘤复发部位，尤其是确定导致局部复发的高危肿瘤亚体积。
10例局部区域复发的NSCLC患者在根治性放化疗（ChRT，66 Gy）前、治疗期间及治疗后4 - 12个月接受了PET/CT联合扫描。对肿瘤进行了形态学和代谢体积测量，并评估了FDG摄取动力学。
所有患者放疗后CT显示肿瘤体积部分缩小。放疗期间，PET显示8例患者部分缓解，2例患者完全代谢缓解。放疗后6至9个月，两种方法均诊断出所有患者局部复发。肿瘤复发主要位于原发肿瘤治疗前代谢最活跃的区域。
NSCLC的局部复发最常见于原发部位及放疗靶区内FDG摄取最高的区域。这一观察结果可能有助于进一步优化NSCLC的放疗方案，例如，对FDG摄取较高的原发肿瘤亚体积增加额外的辐射剂量。
