Ulger Sukran, Demirci Nilgun Yilmaz, Aydinkarahaliloglu Ercan, Kahraman Fatih Caglar, Ozmen Ozlem, Erdogan Yurdanur, Cetin Eren, Avci Emine, Cengiz Mustafa
1 Department of Radiation Oncology, 2 Department of Chest Disease, Faculty of Medicine, Gazi University, Ankara, Turkey ; 3 Department of Radiation Oncology, 4 Department of Nuclear Medicine, 5 Department of Chest Disease, Ataturk Chest Disease and Thoracic Surgery Training and Research Hospital, Ankara, Turkey ; 6 Department of Public Health, Faculty of Medicine, Gazi University, Ankara, Turkey ; 7 Department of Radiation Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
J Thorac Dis. 2015 Mar;7(3):295-302. doi: 10.3978/j.issn.2072-1439.2015.02.02.
The prognosis of small cell lung cancer (SCLC) has been improving with the advances in diagnostic and therapeutic modalities. Positron emission tomography/computed tomography (FDG-PET/CT) which has been studied in non-small cell lung cancer (NSCLC) for a long time, and it has only recently been applied to SCLC. Therefore we sought to observe firstly the prognostic importance of the FDG uptake in limited disease small cell lung cancer (LD-SCLC) patients and secondly the clinical outcomes and toxicity profiles of LD-SCLC patients treated with conformal radiation therapy (RT) using FDG-PET/CT simulation.
Between 2009 and 2011, 33 LD-SCLC patients with LD-SCLC underwent disease staging using FDG-PET/CT conformal RT. Thoracic radiation was administered at a daily fraction of 2 Gy. Total dose was prescribed according to the treatment protocol such as, concurrent or sequential chemotherapy and in some patients according to the response of CT. All patients underwent chemotherapy. Survival was estimated using the Kaplan-Meier method.
The median age of the patients was 58 years (range, 38-77 years). The median follow-up time was 20 months (range, 6.6-47.6 months). The 3-year overall survival (OS) and locoregional control rates were 23% and 48%, respectively.
There are few studies examining the impact of PET-CT and the prognostic significance of FDG-uptake on outcomes in patients with LD-SCLC. Higher RT doses in response to higher FDG uptake may be safely applied for the purpose of locoregional control.
随着诊断和治疗方式的进步，小细胞肺癌（SCLC）的预后一直在改善。正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）长期以来一直在非小细胞肺癌（NSCLC）中进行研究，直到最近才应用于SCLC。因此，我们首先试图观察FDG摄取在局限期小细胞肺癌（LD-SCLC）患者中的预后重要性，其次观察使用FDG-PET/CT模拟进行适形放疗（RT）的LD-SCLC患者的临床结局和毒性特征。
在2009年至2011年期间，33例LD-SCLC患者接受了使用FDG-PET/CT适形RT进行的疾病分期。胸部放疗每天分次给予2 Gy。总剂量根据治疗方案规定，如同步或序贯化疗，部分患者根据CT反应而定。所有患者均接受化疗。使用Kaplan-Meier方法估计生存率。
患者的中位年龄为58岁（范围38-77岁）。中位随访时间为20个月（范围6.6-47.6个月）。3年总生存率（OS）和局部区域控制率分别为23%和48%。
很少有研究探讨PET-CT的影响以及FDG摄取对LD-SCLC患者结局的预后意义。为了局部区域控制，可以安全地应用针对更高FDG摄取的更高放疗剂量。
