功能影像检测食管癌放疗过程中再增殖和乏氧以及预测临床疗效研究

研究中18F-FLT PET能监测食管鳞癌放疗过程中肿瘤和正常组织的生物学变化，其较18F-FDG PET能较好区分炎症和肿瘤，能检测食管肿瘤放疗过程中的加速再增殖。18F-FETNIM PET能检测食管鳞癌的乏氧状态。18F-FLT PET/CT能在治疗开始后一周预测食管癌同步放化疗的临床疗效，治疗前SUVmax能预测食管鳞癌同步放化疗疗效。18F-FLT PET和18F-FETNIM PET作为一种非创伤性的影像学技术，能为肿瘤医生提供一个早期评价治疗反应，检测放疗过程中的再增殖克隆源细胞、乏氧和评价新辅助治疗疗效的手段。18F-FLT PET和18F-FETNIM PET能为放射治疗确定“再增殖”和“乏氧”生物学靶区，以通过剂量调强放疗提高再增殖和乏氧区域放疗剂量，提高肿瘤的局部控制率和远期生存。

clinical response with functional image during radiotherapy of esophageal squamous cell carcinoma

Radiation therapy (RT) plays an important role in the treatment of locally advanced esophageal cancer. Treatment effectiveness may be limited by accelerated repopulation of clonogenic tumor cells and tumor hypoxia, which are associated with increased aggressiveness, enhanced metastatic potential and poor prognosis. 18F-FLT uptake can be used to monitor the biological response of esophageal SCC and normal tissue to RT. Increased uptake of 18F-FLT following treatment interruptions may reflect accelerated repopulation. 18F-FLT PET may have advantages compared to 18F-FDG PET at differentiating inflammation from tumor. 18F-FLT PET may help oncologists predict treatment response as early as one week after the beginning of treatment and estimate clonogenic repopulation during RT. 18F-FETNIM PET can depict hypoxia in esophageal SCC. Prior to CCRT, tumor hypoxia demonstrates spatial variability on different days, though overall 18F-FETNIM uptake remains similar. Baseline SUVmax may be predictive of treatment response.