PETCT显像对肺癌分期及临床治疗决策的影响.pptVIP

PET/CT显像对肺癌分期及 临床治疗决策的影响 研究背景 Cancer Incidence, Mortality, and Associated Risk Factors Among Asian Americans CA Cancer J Clin 2007;57:190–205 早期诊断 明确分期 指导治疗 再分期 评价效果 预测疗效 三.目前研究动态 changed the stage in 44 patients (22.2%). upstaged 32 of 198 patients (16.2%) , downstaged 12 patients (6.1%)。 changed management in 143 patients (72.2%). changed diagnostic management in 105 of 198 patients (53%), among whom biopsy was deferred in 65 patients (61.9%) and was triggered or guided in 40 patients (38.1%). altered treatment decisions in 38 patients (19.2%), leading to neoadjuvant therapy in 6patients and resection in 5 patients, and forestalling noncurative thoracotomy in 6 patients. PETscan findings prompted or redirected chemotherapy or radiotherapy in the remainder of the patients. triggered additional diagnostic testing in 32 patients (16.2%) esulting in no new diagnosis in 16 patients (50%) and a critical change in management in 7 patients (21.9%). a significant non-lung cancer diagnosis in eight patients (4%). life-saving consequences in 2.0% facilitating curativeresection in 4 patients. The Impact of Positron Emission Tomography on Clinical Decision Making in a University-Based Multidisciplinary Lung Cancer Practice Chest 2005;128;698-703 Compared with PET data alone, PET/CT findings led to a change in tumor stage in seven patients (26%). For four patients (15%), this change directly affected the treatment plan. D Preliminary results on the role of PET/CT in initial staging, restaging, and management of lung cancer Nuclear Instruments Methods in Physics Research Section Dec2006, Vol. 569 Issue 2, p319-322 国内 18F-FDGhPET/CT显像使 27例NSCLC患者分期改变 ,其中分期升级20例,分期降级7例。 14例分期升级 者18F-FDGhPET/CT显像检查发现了远处转移灶,其治疗方案由根治性治疗改为姑息性治疗。 FDG显像较CT多发现了 47个转移淋巴结,并对其进 行了放疗;多发现了26个远 处转移灶,并对其进行了姑息性放疗。 研究目的 探讨18F-FDG PET/CT显像对肺癌TNM分期及再分期的影响 明确18F-FDG PET/CT显像对临床医生决策的影响 评价18F-FDG PET/CT显像监测肺癌治疗疗效的价值 研究内容 18F-FDG PET/CT 显像 临床分期(TNM) 治疗方案(手术、化疗、放