中国医科大学学报

中国医科大学学报
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中国医科大学学报 ›› 2017, Vol. 46 ›› Issue (12): 1095-1100.doi: 10.12007/j.issn.0258-4646.2017.12.009

• 论著 • 上一篇    下一篇

1H磁共振波谱在非小细胞肺癌脑转移放疗疗效评价中的预测价值

贺政, 李光, 张宏伟, 张硕   

  1. 中国医科大学附属第一医院放射治疗科, 沈阳 110001
  • 收稿日期:2017-09-15 出版日期:2017-12-30 发布日期:2017-12-08
  • 通讯作者: 李光 E-mail:13804058616@163.com
  • 作者简介:贺政(1982-),男,主治医师,博士.
  • 基金资助:
    辽宁省科学技术计划(2013225021)

Predictive Value of Proton Magnetic Resonance Spectroscopy in the Evaluation of Radiotherapy for Patients with Brain Metastases from Non-small Cell Lung Cancer

HE Zheng, LI Guang, ZHANG Hongwei, ZHANG Shuo   

  1. Department of Radiotherapy, The First Hospital, China Medical University, Shenyang 110001, China
  • Received:2017-09-15 Online:2017-12-30 Published:2017-12-08

摘要: 目的 探讨1H磁共振波谱(1H-MRS)在非小细胞肺癌(NSCLC)脑转移放疗疗效评价中的预测价值。方法 接受立体定向放疗(SRT)联合全脑照射(WBRT)的56例NSCLC脑转移患者在治疗前应用1H-MRS进行检查,测量Cho/Cr的比值,比较治疗前Cho/Cr比值高组与Cho/Cr比值低组间疗效的差异,分析1H-MRS在NSCLC脑转移放疗疗效评价中的预测价值。结果 治疗前Cho/Cr比值中位值为1.989。治疗前Cho/Cr比值高组(>1.989)1、3、5年生存率分别为29.3%(95% CI:11.3%~47.3%)、0%、0%,平均生存时间为9.77个月(95% CI:7.50~12.04个月)。Cho/Cr比值低组(<1.989)1、3、5年生存率分别为70.5%(95% CI:53.3%~87.7%)、22.3%(95% CI:6.6%~38.0%)、1.8%(95% CI:0~8.1%),平均生存时间为24.67个月(95% CI:17.69~31.66个月)。治疗前Cho/Cr比值高组与Cho/Cr比值低组比较平均生存时间有统计学差异(P < 0.05)。结论 1H-MRS对NSCLC脑转移放疗的疗效评价具有预测价值,治疗前Cho/Cr比值高组预后差。

关键词: 1H磁共振波谱, 非小细胞肺癌, 脑转移, 放射疗法, 预后

Abstract: Objective To investigate the predictive value of proton magnetic resonance (MR) spectroscopy (1H-MRS) in evaluating the therapeutic efficacy of radiotherapy for patients with brain metastases from non-small cell lung cancer (NSCLC). Methods Fifty-six patients with brain metastases from NSCLC underwent 1H-MRS examination before treatment with stereotactic radiotherapy (SRT) in addition to whole brain radiotherapy (WBRT). The patients were divided into two groups according to their pretreatment choline-to-creatinine (Cho/Cr) ratio. The therapeutic efficacy of radiotherapy was compared between the two groups,and the prognostic value of 1H-MRS examination was analyzed. Results The median pretreatment Cho/Cr was 1.989. The overall survival rates at 1,3,and 5 years were 29.3%,0%,and 0% in patients with higher pretreatment Cho/Cr,and 70.5%,22.3%,and 1.8% in those with lower pretreatment Cho/Cr. The mean survival time was significantly lower in patients with higher pretreatment Cho/Cr than in those with lower pretreatment Cho/Cr (9.77 vs. 24.67 months,P < 0.05). Conclusion Pretreatment Cho/Cr has a predictive value in the evaluation of radiotherapy for the treatment of NSCLC brain metastasis. Patients with higher pretreatment Cho/Cr have worse prognosis overall.

Key words: proton magnetic resonance spectroscopy, non-small cell lung cancer, brain metastasis, radiotherapy, prognosis

中图分类号: 

  • R734.2
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