18F-FDG PET/CT指导食管鳞癌放疗局部加量的临床效果及预后分析-《中国医学物理学杂志》

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Title:: Clinical efficacy and prognosis analysis of 18F-FDG PET/CT-guided dose escalation in radiotherapy for esophageal squamous cell carcinoma

文章编号:: 1005-202X（2026）01-0009-05

作者:: 石明宏1; 刘占伟2; 朱洋2; 夏丽丽2; 白刚1; 程刚3; 陆友国2; 1.淮南新华医疗集团新华医院放疗科，安徽淮南 232000； 2.淮南新华医疗集团新华医院肿瘤科，安徽淮南 232000； 3.亳州市人民医院肿瘤科，安徽亳州 236805

Author(s):: SHI Minghong1; LIU Zhanwei2; ZHU Yang2; XIA Lili2; BAI Gang1; CHENG Gang3; LU Youguo2; 1. Department of Radiotherapy, Xinhua Hospital of Huainan Xinhua Medical Group, Huainan 232000, China 2. Department of Oncology, Xinhua Hospital of Huainan Xinhua Medical Group, Huainan 232000, China 3. Department of Oncology, the Peoples Hospital of Bozhou, Bozhou 236805, China

关键词:: 氟代脱氧葡萄糖; 正电子发射计算机断层显像; 食管鳞癌; 放射治疗; 临床效果; 预后

Keywords:: Keywords: fluorodeoxyglucose positron emission computed tomography esophageal squamous cell carcinoma radiotherapy clinical efficacy prognosis

分类号:: R816.5

DOI:: DOI:10.3969/j.issn.1005-202X.2026.01.002

文献标志码:: A

摘要:: 目的：研究18F-FDG PET/CT指导食管鳞癌（ESCC）放疗局部加量的临床效果及预后分析。方法：回顾性分析经病理确诊的88例ESCC患者的临床资料，患者均接受局部加量放疗，收集患者18F-FDG PET/CT代谢参数，包括最大标准摄取值（SUVmax）、全身肿瘤代谢体积（MTVwb）、全身病灶糖酵解总量（TLGwb），采用Kaplan-Meier法、Log-Rank检验及多因素COX回归分析上述参数与患者总生存时间（OS）的关系。结果：①患者2年生存率为59.09%，中位OS为17.3（15.2~24.0）个月；②单因素分析结果显示，临床分期、肿瘤直径、手术治疗、SUVmax、MTVwb、TLGwb与患者OS有关（P<0.05）；③Kaplan-Meier生存分析显示，代谢参数SUVmax≤12.84患者的2年生存率高于SUVmax>12.84的患者（61.11% vs 32.69%, P<0.05），MTVwb≤10.12患者的2年生存率高于MTVwb>10.12的患者（73.91% vs 47.62%, P<0.05），TLGwb≤148.67患者的2年生存率高于TLGwb>148.67的患者（73.33% vs 44.19%, P<0.05）；④COX多因素分析显示，参数MTVwb和TLGwb是影响患者OS的独立危险因素（P<0.05）。结论：18F-FDG PET/CT指导ESCC患者放疗局部加量治疗效果明显，该检查显像所获得的MTVwb及TLGwb是ESCC患者预后的独立危险因素，且对ESCC患者预后有较好的预测效能。

Abstract:: Abstract: Objective To investigate the clinical efficacy and prognosis of 18F-FDG PET/CT-guided radiotherapy dose escalation in esophageal squamous cell carcinoma (ESCC). Methods The clinical data of 88 patients with ESCC confirmed by pathological diagnosis were retrospectively analyzed. All patients received radiotherapy with dose escalation. The 18F-FDG PET/CT metabolic parameters were collected, including maximum standard uptake value (SUVmax), whole body metabolic tumor volume (MTVwb), and whole body total lesion glycolysis (TLGwb). Kaplan-Meier method, Log-Rank test, and multivariate COX regression analysis were used to analyze the relationships between the above parameters and overall survival (OS). Results The 2-year survival rate was 59.09%, with a median OS of 17.3 (15.2-24.0) months. Univariate analysis showed that clinical stage, tumor diameter, surgical treatment, SUVmax, MTVwb, and TLGwb were associated with OS (P<0.05). Kaplan-Meier survival analysis revealed that the 2-year OS rates were 61.11% for patients with SUVmax≤12.84 versus 32.69% for those with SUVmax > 12.84 (P<0.05), 73.91% for patients with MTVwb≤10.12 versus 47.62% for those with MTVwb>10.12 (P<0.05), and 73.33% for patients with TLGwb≤148.67 versus 44.19% for those with TLGwb>148.67 (P<0.05). Multivariate COX regression analysis identified MTVwb and TLGwb as independent risk factors affecting OS (P<0.05). Conclusion 18F-FDG PET/CT-guided dose escalation in radiotherapy exerts a significant therapeutic effect in ESCC patients. The obtained MTVwb and TLGwb are independent risk factors for the prognosis of ESCC patients, and have favorable predictive efficacy for the prognosis of ESCC patients.

《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

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