Increased 18F-deoxyglucose uptake in the lung during the first weeks of radiotherapy is correlated with subsequent Radiation-Induced Lung Toxicity (RILT): A prospective pilot study
Increased 18F-deoxyglucose uptake in the lung during the first weeks of radiotherapy is correlated with subsequent Radiation-Induced Lung Toxicity (RILT): A prospective pilot study
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DOI：
10.1016/j.radonc.2009.01.004
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发表时间：
2009-06-01
影响因子：
5.7
通讯作者：
Lambin, Philippe
中科院分区：
文献类型：
--
作者：
De Ruysscher, Dirk;Houben, Ans;Lambin, Philippe
目的：由于放射诱导肺毒性 (RILT) 是肺癌放射治疗 (RT) 的剂量限制，且当前参数与 RILT 仅有中度相关，因此我们寻找与 RILT 相关的新参数。 患者和方法：在这项前瞻性研究中，对 18 名 III 期非小细胞肺癌患者在开始高剂量 RT 后第 0、7 和 14 天进行 FDG-PET-CT 扫描。使用 GTV 之外的肺中的最大标准化摄取值 (SUV(max)) 作为 FDG 摄取的量度。在同一时间点，测量血清IL-6浓度。 RILT 定义为呼吸困难评分 >= 2 (CTCAE3.0)。结果：18 名患者中有 6 名出现 RILT。 RT 之前，发生 RILT 的患者和未发生 RILT 的患者之间肺部 SUV(max) 没有显着差异。放疗后发生 RILT 的患者在放疗期间第 7 天和第 14 天的 SUV 显着增加，而未经历 RILT 的患者则没有表现出显着的 SUV 变化。与未发生 RILT 的组相比，后来发生 RILT 的组肺部 SUV(max) 显着增加。 IL-6 浓度和平均肺剂量均与 RILT 无关。结论：RT 早期正常肺中 FDG 摄取的增加与临床 RILT 的后续发展高度相关。当仍有可能调整治疗或预防 RILT 策略时，这可能有助于识别 RILT 高风险患者。 (C) 2009 Elsevier Ireland Ltd. 保留所有权利。放射治疗和肿瘤学91（2009）415-420
Purpose: As Radiation-Induced Lung Toxicity (RILT) is dose-limiting for radiotherapy (RT) of lung cancer and current parameters are only moderately associated with RILT, we sought for novel parameters associated with RILT.Patients and methods: In this prospective study, FDG-PET-CT scans were taken on days 0, 7 and 14 after initiation of high-dose RT in 18 patients with stage III non-small cell lung cancer. The maximal Standardized Uptake Value (SUV(max)) in the lung Outside of the GTV was used as a measure of FDG uptake. At the same time-points, the serum IL-6 concentrations were measured. RILT was defined as dyspned score >= 2 (CTCAE3.0).Results: Six of 18 patients developed RILT. Before RT, SUV(max) in the lung was not significantly different between patients who developed RILT and those who did not develop RILT. Patients who developed RILT post-radiation had a significant increased SUV on days 7 and 14 during RT, whereas the group that did not experience RILT showed no significant SUV changes. The SUV(max) of the lungs increased significantly more in the group that later developed RILT compared to those who did not develop RILT. Neither the IL-6 concentration nor the mean lung dose was associated with RILT.Conclusions: The increase in FDG uptake in the normal lung early during RT was highly associated with the subsequent development of clinical RILT. This may help to identify patients at high risk for RILT at a time when adjustments of the treatment or strategies to prevent RILT are still possible. (C) 2009 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 91 (2009) 415-420