Small Cell Lung Carcinoma: Staging, Imaging, and Treatment Considerations
Small Cell Lung Carcinoma: Staging, Imaging, and Treatment Considerations
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DOI：
10.1148/rg.346140178
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发表时间：
2014-10-01
期刊：
影响因子：
5.5
通讯作者：
Erasmus, Jeremy J.
中科院分区：
文献类型：
--
作者：
Carter, Brett W.;Glisson, Bonnie S.;Erasmus, Jeremy J.
小细胞肺癌（SCLC）是最常见的原发性肺神经内分泌恶性肿瘤，其特征是快速倍增时间和高生长分数。大约60%-70%的患者在诊断时患有转移性疾病，并且预后较差。然而，当SCLC被早期诊断并使用特定的治疗策略时，已经证明了生存率的提高。退伍军人管理局肺癌研究组（VALSG）分期系统的修改版本传统上用于将SCLC分类为有限期或广泛期疾病以指导治疗。然而，国际肺癌研究协会（International Association for the Study of Lung Cancer）建议，目前第七版的美国癌症联合委员会（American Joint Committee on Cancer）肺癌肿瘤-淋巴结-转移分期系统（tumor-node-metastasis staging system for lung cancer）取代VALSG系统用于SCLC分期。适当的分期和患者管理需要了解SCLC的多种影像学表现，具体检查的优点和缺点，这些发现与临床实践中使用的分期标准的相关性，以及适当分期对患者治疗和生存的影响。计算机断层扫描（CT）主要用于评估原发肿瘤和胸内疾病的程度。然而，近年来，2-[氟-18]氟-2-脱氧-D-葡萄糖正电子发射断层扫描/CT已被证明在SCLC分期方面比传统成像更准确，可用于指导治疗和评估治疗反应。(C)RSNA，2014年。radiographics.rsna.org
Small cell lung carcinoma (SCLC) is the most common primary pulmonary neuroendocrine malignancy and is characterized by a rapid doubling time and high growth fraction. Approximately 60%-70% of patients present with metastatic disease at the time of diagnosis, and their prognosis is poor. However, improved survival has been demonstrated when SCLC is diagnosed early and specific treatment strategies are used. A modified version of the Veterans Administration Lung Cancer Study Group (VALSG) staging system has traditionally been used to categorize SCLC as limited-stage or extensive-stage disease to guide therapy. However, the International Association for the Study of Lung Cancer has recommended that the current seventh edition of the American Joint Committee on Cancer tumor-node-metastasis staging system for lung cancer replace the VALSG system for staging of SCLC. Appropriate staging and patient management require knowledge of imaging manifestations of SCLC across multiple imaging modalities, the strengths and weaknesses of specific examinations, the correlation of these findings with the staging criteria used in clinical practice, and the impact of appropriate staging on patient treatment and survival. Computed tomography (CT) is primarily used to evaluate the primary tumor and the extent of intrathoracic disease. In recent years, however, 2-[fluorine-18] fluoro-2-deoxy-D-glucose positron emission tomography/CT has proved to be more accurate than conventional imaging in the staging of SCLC and can be used to guide therapy and assess treatment response. (C) RSNA, 2014 . radiographics.rsna.org