中期铊-201闪烁扫描术预测骨与软组织肿瘤的肿瘤反应。

Midcourse thallium-201 scintigraphy to predict tumor response in bone and soft-tissue tumors.

作者信息

Sumiya H, Taki J, Tsuchiya H, Nonomura A, Miyauchi T, Tonami N

机构信息

Department of Nuclear Medicine, Kanazawa University School of Medicine, Japan.

出版信息

J Nucl Med. 1998 Sep;39(9):1600-4.

PMID:9744351

Abstract

UNLABELLED

The purpose of this study was to assess the predictive power of 201TI scintigraphy in the midcourse of chemotherapy for the final tumor response to chemotherapy in malignant bone and soft-tissue tumors.

METHODS

The 21 patients studied with 201TI scintigraphy were 14 males and 7 females (average age 39.8+/-22.1 yr; age range 8-74 yr). Planar scintigraphy was performed 15 min after injection of 111 MBq 201TI before chemotherapy, after the third chemotherapy cycle (midcourse) in all 21 patients and after the final chemotherapy cycle but before surgery in 11 patients. The 201TI uptake ratio was calculated by dividing the count density of the lesion by that of the contralateral normal area. The percent reduction of the 201TI uptake ratio calculated by 100 x [(prechemotherapy ratio - postchemotherapy ratio)/prechemotherapy ratio] in the midcourse was compared with that after the final course of chemotherapy, and it also was compared with the histologic response.

RESULTS

In patients with histologically complete response [(CR), n=6] and with partial response [(PR), n=5], the percent reduction in 201TI uptake ratio after three cycles of chemotherapy was 64.1%+/-14.4% and 50.9% +/-10.5%, respectively. In patients with histologically no change [(NC), n=10], the percent reduction was 0.40%+/-18.2% after the third cycle; -5.3%+/-20.9% in four patients with full courses of chemotherapy (p < 0.0001 and p < 0.005 compared with the CR and PR groups, respectively). After the final cycle of chemotherapy, the percent reduction in 201TI uptake ratio was 68.6%+/-14.7%, 56.2%+/-6.1% and -0.3%+/-17.2% in the CR, PR and NC groups, respectively (NC versus CR, p < 0.0005; NC versus PR, p < 0.005).

CONCLUSION

Thallium-201 scintigraphy performed in the midcourse of chemotherapy is predictive of the final response to chemotherapy that can be demonstrated histologically. Serial 201TI scintigraphy in the midcourse of chemotherapy is useful in assessing final chemotherapeutic response in the early stage of chemotherapy, and it helps clinicians when choosing the most appropriate treatment strategies in patients with bone and soft-tissue tumors.

摘要

未标注

本研究的目的是评估201铊闪烁扫描术在恶性骨与软组织肿瘤化疗中期对化疗最终肿瘤反应的预测能力。

方法

接受201铊闪烁扫描术研究的21例患者中，男性14例，女性7例（平均年龄39.8±22.1岁；年龄范围8 - 74岁）。在化疗前注射111 MBq 201铊后15分钟进行平面闪烁扫描，所有21例患者在第三个化疗周期（中期）后进行扫描，11例患者在最后一个化疗周期后但手术前进行扫描。201铊摄取率通过将病变部位的计数密度除以对侧正常区域的计数密度来计算。计算中期201铊摄取率的降低百分比，公式为100×[(化疗前摄取率 - 化疗后摄取率)/化疗前摄取率]，并与化疗最后疗程后的降低百分比进行比较，同时也与组织学反应进行比较。

结果

组织学完全缓解（CR，n = 6）和部分缓解（PR，n = 5）的患者，三个化疗周期后201铊摄取率的降低百分比分别为64.1%±14.4%和50.9%±10.5%。组织学无变化（NC，n = 10）的患者，第三个周期后降低百分比为0.40%±18.2%；4例完成全部化疗疗程的患者降低百分比为 - 5.3%±20.9%（分别与CR组和PR组相比，p < 0.0001和p < 0.005）。化疗最后周期后，CR、PR和NC组201铊摄取率的降低百分比分别为68.6%±14.7%、56.2%±6.1%和 - 0.3%±17.2%（NC与CR相比，p < 0.0005；NC与PR相比，p < 0.005）。