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目的初步探讨99Tcm-EC-MN(99锝-双半胱氨酸-甲硝唑)SPECT显像对预测鼻咽癌乏氧状况的可行性及临床价值。方法在放疗前对15例鼻咽癌初治病例进行99Tcm-EC-MN SPECT显像,测定鼻咽原发病灶肿瘤T/N值(放射性计数/正常组织放射性计数比值),并随访治疗疗效。结果15例鼻咽原发病灶的T/N值为0.91~3.51(平均值为2.14),放疗后15例中,CR 8例,PR 7例;其3年总生存率、局部控制率和无远地转移率分别为53.3%、79.0%和86.2%。T/N值≤2.14和>2.14组的治疗反应率、总生存率、局部控制率和无远地转移率差异均无统计学意义(P>0.05)。结论99Tcm-EC-MN SPECT显像能安全地用于鼻咽癌乏氧的检测;肿瘤之间不同的T/N值提示鼻咽原发灶均存在不同程度的乏氧现象,但其临床应用价值不能肯定。
Objective To investigate the feasibility and clinical value of 99Tcm-EC-MN (99Tc-bis-cysteine-metronidazole) SPECT imaging in prediction of hypoxia in nasopharyngeal carcinoma. Methods Fifty-five cases of nasopharyngeal carcinoma were treated with 99Tcm-EC-MN SPECT before radiotherapy. The tumor T / N value (radioactive count / normal tissue radioactivity count) of nasopharyngeal primary tumor was measured and followed up. Results The T / N values of 15 primary nasopharyngeal lesions were 0.91-3.51 (mean 2.14). Among the 15 cases after radiotherapy, 8 cases were CR and 7 cases were PR. The 3-year overall survival rate, local control rate and no The distant metastasis rates were 53.3%, 79.0% and 86.2% respectively. There was no significant difference in the treatment response rate, overall survival rate, local control rate and no distant metastasis rate between T / N value≤2.14 and> 2.14 group (P> 0.05). Conclusions 99Tcm-EC-MN SPECT imaging can be safely applied to the detection of hypoxia in nasopharyngeal carcinoma. Different T / N values suggest different degrees of hypoxia in the nasopharyngeal tissues. However, its clinical application Value can not be sure.