Kim H J, Boyd J, Dunphy F, Lowe V
Department of Radiation Oncology, Saint Louis University, Missouri, USA.
Clin Nucl Med. 1998 Nov;23(11):750-2. doi: 10.1097/00003072-199811000-00006.
Fluorine-18-fluorodeoxyglucose (F-18 FDG) PET was used to evaluate early-stage larynx cancer before and after radiotherapy. Less radical salvage surgery might be possible after timely diagnosis of recurrent or persistent tumor after radiotherapy. Eight patients with early-stage laryngeal cancer (two carcinoma in situ; six stage T1: tumor limited to vocal cords with normal mobility) underwent irradiation for potential cure. Five patients had pre- and postradiotherapy F-18 FDG PET, and three had postradiotherapy F-18 FDG PET only. All patients underwent a CT scan of the neck at the time of the F-18 FDG PET scan. One patient had a positive result of postradiotherapy F-18 FDG PET but a negative result of a CT of the neck, and biopsy revealed recurrent squamous carcinoma. Seven patients who had negative results of postradiotherapy F-18 FDG PET were free of disease at the 15-month median follow-up evaluation. (Three of them had no cancer on biopsy of the larynx, and four others were followed with periodic endoscopic examinations that revealed complete disappearance of the tumor.) F-18 FDG PET scan may be useful for earlier diagnosis of recurrent or persistent laryngeal cancer after radiotherapy and is preferable to repeated biopsies, which would traumatize radiation-damaged tissues. A prompt early diagnosis of failure of radiotherapy will lead to less radical salvage surgery.
采用氟-18-氟脱氧葡萄糖（F-18 FDG）PET对早期喉癌放疗前后进行评估。放疗后及时诊断出复发或持续性肿瘤后，可能可行不太激进的挽救性手术。8例早期喉癌患者（2例原位癌；6例T1期：肿瘤局限于声带且活动正常）接受了旨在治愈的放疗。5例患者在放疗前后均进行了F-18 FDG PET检查，3例仅在放疗后进行了F-18 FDG PET检查。所有患者在进行F-18 FDG PET扫描时均接受了颈部CT扫描。1例患者放疗后F-18 FDG PET检查结果为阳性，但颈部CT检查结果为阴性，活检显示为复发性鳞状细胞癌。7例放疗后F-18 FDG PET检查结果为阴性的患者在中位随访15个月时无疾病。（其中3例喉部活检无癌症，另外4例通过定期内镜检查随访，显示肿瘤完全消失。）F-18 FDG PET扫描可能有助于放疗后复发性或持续性喉癌的早期诊断，并且优于重复活检，因为重复活检会损伤受辐射损伤的组织。放疗失败的早期快速诊断将导致不太激进的挽救性手术。
