Kung Boom Ting, Yong Ting Kun Au, Tong Cheuk Man
Nuclear Medicine and Hospital Authority Clinical PET/CT Centre, Queen Elizabeth Hospital, Kowloon, Hong Kong, China.
World J Nucl Med. 2017 Jan-Mar;16(1):21-25. doi: 10.4103/1450-1147.176882.
The aim of this retrospective study is to evaluate the clinical impact and efficacy of fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) on management decisions for patients suffering from clinically operable non-small-cell lung cancer (NSCLC). A retrospective review of 186 potentially operable NSCLC patients who underwent whole-body PET/CT examination in 2012 was performed. The patients were further analyzed via the electronic patient record (ePR) system for relevant findings. Overall change in management was assigned if a patient avoided unnecessary surgery due to disease upstaging or if a patient underwent further neoadjuvant treatment or investigation before the curative surgery. Of all 186 subjects, 65 (34.9%) became inoperable after PET/CT due to disease upstaging. The remaining 121 (65.1%) of patients remained operable after PET/CT examination. Nineteen out of 121 potentially operable patients did not receive curative surgery eventually, as 11 patients had poor clinical condition and 8 patients refused surgery. One hundred two out of 186 (54.8%) patients received curative operation following PET/CT. Among these 102 individuals, 97 patients (95%) proceeded to surgery without further neoadjuvant treatment or other investigatory procedures. Of the remaining 5 patients, 4 (3.9%) received neoadjuvant treatment and 1 (1.0%) had further investigation after PET/CT. Seventy of the 186 (37.6%) patients underwent changes in management plans after PET/CT study. Out of the 186 individuals, a subgroup of 141 (75.8%) patients underwent dedicated CT thorax before PET/CT examination. Forty-seven (33.3%) patients had avoided futile surgery due to disease upstaging. Fifty-one of the 141 (36.2%) patients underwent changes in management plans after PET/CT. PET/CT had great clinical impact, with significant reduction of futile curative surgery.
这项回顾性研究的目的是评估氟脱氧葡萄糖（FDG）正电子发射断层扫描-计算机断层扫描（PET/CT）对临床可手术的非小细胞肺癌（NSCLC）患者治疗决策的临床影响和疗效。对2012年接受全身PET/CT检查的186例可能可手术的NSCLC患者进行了回顾性分析。通过电子病历（ePR）系统对患者的相关检查结果进行进一步分析。如果患者因疾病分期升级而避免了不必要的手术，或者在根治性手术前接受了进一步的新辅助治疗或检查，则判定管理方案有总体变化。在所有186名受试者中，65例（34.9%）在PET/CT检查后因疾病分期升级而无法手术。其余121例（65.1%）患者在PET/CT检查后仍可手术。121例可能可手术的患者中有19例最终未接受根治性手术，其中11例患者临床状况较差，8例患者拒绝手术。186例患者中有102例（54.8%）在PET/CT检查后接受了根治性手术。在这102例患者中，97例（95%）直接进行了手术，未接受进一步的新辅助治疗或其他检查程序。其余5例患者中，4例（3.9%）接受了新辅助治疗，1例（1.0%）在PET/CT检查后进行了进一步检查。186例患者中有70例（37.6%）在PET/CT检查后改变了治疗方案。在186名患者中，有141例（75.8%）在PET/CT检查前接受了胸部专用CT检查。47例（33.3%）患者因疾病分期升级而避免了无效手术。141例患者中有51例（36.2%）在PET/CT检查后改变了治疗方案。PET/CT具有重大的临床影响，显著减少了无效的根治性手术。
