VAI TRÒ CỦA PET/CT TRONG CHẨN ĐOÁN GIAI ĐOẠN VÀ LẬP KẾ HOẠCH XẠ TRỊ UNG THƯ PHỔI KHÔNG TẾ BÀO NHỎ GIAI ĐOẠN III TẠI BỆNH VIỆN K

Abstract

Objective: The study was performed to evaluate the role of 18-FDG PET before radiation planning in radiotherapy planning and treatment strategy. Research methods: Patients with inoperable stage III non-small cell lung cancer were initially diagnosed with 64-row whole-body CT, brain MRI and bone scintigraphy. These patients will have an 18FDG-PET scan, and in case the stage remains the same, radiotherapy will be planned. In the first step, the doctor will plan radiation therapy based on the simulated CT scan and not the results of the PET/CT. The same doctor will rework the patient's plan based on the results of the PET/CT. The 2 plans of each patient will be compared PTV, mean lung radiation dose, lung V20 dose, marrow Dmax dose, cardiac V50, and mean esophageal dose. Results: In the 35 patients studied, additional distant metastatic lesions were detected after PET scan in 8 patients (22.8%), these patients will switch from the goal of radical treatment to palliative treatment. Of the 27 patients who maintained the same stage, the radiotherapy plan was adjusted in 15 patients (55.5%), of which, 4 patients had separate lung collapse and cancerous lesions. 10 patients had additional lymph node lesions (37%) and 1 other lobar parenchymal lesion. Increasing the radiation volume leads to an increase in mean lung radiation dose, lung V20 and mean esophageal dose. Changing the radiation volume in patients with atelectasis leads to reduced toxicity to healthy organs. Conclusion: PET/CT has high value in detecting distant metastatic lesions and lung lesions, especially metastatic mediastinal lymph nodes. PET/CT evaluation of patients with non-small cell lung cancer before treatment showed significant changes in the patient's treatment strategy and radiotherapy plan.