| ObjectivesChemotherapy is the main treatment options for advanced lung cancer, recently vascular targeting agents has emerged as a promising therapeutic strategy. As a functional imaging techniques, CT perfusion can provide an in vivo assessment of tumor vascularity that correlate with progress and apoptosis undoubtedly. The aim of the rsearch was to prospectively investigate the value of CTP in the therapeutic assessment on Chemotherapy and vascular targeting agents in the patients with advanced lung cancer.Materials and methodsTwenty patients (13men,7 women; age range 45-74 years, mean age 60.45 years)with histologically proved advanced NSCLC (stage IIIB in 11 patients, stageⅣin 9 patients), each patient signed the informed consent, was divided into two groups randomly for therapy, one with the chemotherapy of GP/DP (the simple group), the other with vascular targeting agents combined with the chemotherapy (the combine group). All of them underwent CTP of primary tumor and a routine thoracic CT examination with a 64-detector row CT scanner (Toshiba Aquillion 64) before and following the therapy within 1 week respectively. Low dose techniques was applied. CT findings were analyzed for tumor size and perfusion parameters (BF,BV, PS, MTT and TP). Statistical analysis was performed by using SPSS for windows 10 software. Results1, The baseline mean perfusion parameters:BV(6.84±6.12), BF(52.22±59.82), PS(21.07±16.94), TP(25.37±5.68), MTT(13.42±4.16); No significant difference was noted between the groups.2, The mean perfusion parameters following the therapy:BV(4.24±3.89), BF(18.90±20.99), PS(13.32±9.10), TP(22.02±4.58), MTT(16.48±5.27).There are significant difference between the groups for BF, BV and PS, no significant difference for TP and MTT.3, Comparing the perfusion parameters before and after the therapy, there are significant difference for BF, BV and PS in the series; for BF, PS and MTT in the combine group; for BF,PS and TP in the simple group. 4, The variation tendency of the perfusion parameters following the therapy: all the mean value of BF, BV, TP and PS were decreased, the mean value of MTT was increased. In the combine group, decreased for BF and BV, decreased in 9 and increased in 1 for PS, decreased in 9 and increased in 1 for MTT, decreased in 7 and increased in 3 for TP. But in the simple group, decreased in 8 cases and increased in 2 cases for BF, decreased in 6 and increased in 4 for BV, decreased in 9 and increased in 1 for PS, decreased in 7 and increased in 3 for TP, decreased in 5 and increased in 5 for MTT.5, Variation in tumor size following the therapy:shrinking in 14 cases, stabilization in 4, growing in 2. Comparing the tumor size before and following the therapy, significant difference was noted in the whole series as well as in the combine group, no significant difference in the simple group.6, Comparing perfusion parameters before and after the therapy, significant difference for BV,BF,TP and PS was..noted in the shrinking series, for none in the stabilization or growing series.7, The variation of PS and BF correlated significantly with variation of tumor size before and following the therapy8, The mean effective dose of a projected examine was about 10mSv, justly corresponding with a route chest CT scanning.Conclusion:1, CT perfusion parameters respond sensitively to chemotherapy in the patients with an advanced lung cancer, and well correlates with tumor shrinking, among them PS and BF are more sensitive and specific。The general tendency of the perfusion parameters following the therapy suggested that BF, BV, TP and PS declined, MTT increased.2, As a vascular targeting agents, Endostatin showed a significant influence to perfusion parameters. Comparing with the simple group, shrinking of tumor was more significant in the combine group.3, With low dose techniques, the radiation dosimetry of a projected examine can be controled under 12 mSv.
|
PDF Full Text Request