29. F-18 FDG PET用于怀疑或证实结肠癌局部复发

Kalff V, Hicks RJ, Ware RE, Binns DS, McKenzie AF
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引用次数: 14

摘要

目的:接受“治愈性”治疗的结直肠癌患者的生存率仍然很低。回顾性研究表明,F-18 FDG PET比CT更准确地重新定位疑似复发性疾病,并有利于治疗。本研究的目的是通过前瞻性分析来证实这一点。患者群体和方法:102例连续患者,转诊临床医生前瞻性地承诺基于常规分期调查的治疗计划,然后进行F-18 FDG PET扫描,评估管理变化和结果。PET结果的准确性通过手术表现或临床随访来评估。结果:102例患者中有66例(65%)改变了治疗方法,其中14例患者在PET局部病变后从观察转为积极治疗,6例患者在PET阴性后计划局部治疗转为观察。28名患者取消了计划手术,11名患者开始了手术。5例患者停止放射治疗,11例开始放射治疗,5例改变放射场。PET结果的准确性在63/66(95%)的患者中进行了评估。50/51例PET阳性患者复发,但有4例疾病程度被低估。5例PET结果为假阴性。结论:FDG PET对疑为复发性疾病患者的患者管理具有高度和适当的影响。PET可以遗漏小体积疾病,但PET的主要好处是防止局部挽救治疗的无效尝试。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
29. F-18 FDG PET for Suspected or Confirmed Regional Recurrence of Colon Cancer

Purpose: Survival of patients (pts) undergoing “curative” treatment for colorectal carcinoma remains poor. Retrospective studies suggest that F-18 FDG PET is more accurate than CT for restaging suspected recurrent disease and favourably impacts management. The aim of this study was to confirm this by prospective analysis.

Patient Population and Methods: 102 consecutive patients for whom the referring clinicians had prospectively committed to a treatment plan based on conventional staging investigations and who then underwent F-18 FDG PET scanning were evaluated for management change and outcome. The accuracy of PET results was assessed by surgical findings or clinical follow-up.

Results: Overall PET changed management in 66/102 (65%) pts including14 pts changed from observation to active treatment after PET localized disease and 6 pts planned for local therapy to observation after negative PET. Planned surgery was cancelled in 28 pts whereas surgery was initiated in 11 pts. Radiotherapy was prevented in 5 pts, initiated in 11 and the radiation field altered in 5 others. The accuracy of the PET results could be assessed in 63/66 (95%) pts in whom management was changed. Relapse was confirmed in 50/51 pts with a positive PET but disease extent was underestimated in 4 cases. False negative PET results were confirmed in 5 cases.

Conclusion: FDG PET has a high and appropriate impact on patient management in patients with suspected recurrent disease. PET can miss small volume disease but the major benefit of PET is to prevent futile attempts at local salvage therapies.

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