[1]邓垒,惠周光,门玉,等.术前临床因素预测pⅢA-N2非小细胞肺癌术后放疗获益人群的研究[J].国际放射医学核医学杂志,2018,(3):224-232.[doi:10.3760/cma.j.issn.1673-4114.2018.03.006]
　Deng Lei,Hui Zhouguang,Men Yu,et al.Preoperative clinical risk factors in selecting patients with pathological ⅢA-N2 non-small-cell lung cancer benefiting from postoperative radiotherapy[J].International Journal of Radiation Medicine and Nuclear Medicine,2018,(3):224-232.[doi:10.3760/cma.j.issn.1673-4114.2018.03.006]
点击复制

术前临床因素预测pⅢA-N2非小细胞肺癌术后放疗获益人群的研究(/HTML)
分享到：

《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
期数:
2018年第3期
页码:
224-232
栏目:
临床研究
出版日期:
2018-05-25

文章信息/Info

Title:
Preoperative clinical risk factors in selecting patients with pathological ⅢA-N2 non-small-cell lung cancer benefiting from postoperative radiotherapy
作者:
邓垒1;  惠周光2;  门玉2;  王文卿1;  肖泽芬1;  冯勤付1;  梁军1;  吕继马1;  周宗玫1;  王绿化1
1. 100021, 国家癌症中心/中国医学科学院北京协和医学院肿瘤医院放疗科;
2. 100021, 国家癌症中心/中国医学科学院北京协和医学院特需医疗部
Author(s):
Deng Lei1;  Hui Zhouguang2;  Men Yu2;  Wang Wenqing1;  Xiao Zefen1;  Feng Qinfu1;  Liang Jun1;  Lyu Jima1;  Zhou Zongmei1;  Wang Lyuhua1
1. Department of Radiation Oncology, National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China;
Department of VIP Medical Services, National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China
关键词:
癌; 非小细胞肺; 放射疗法; 化学疗法; 疗效评价
Keywords:
Carcinoma; non-small-cell lung; Radiotherapy; Chemotherapy; Therapeutic evaluation
DOI:
10.3760/cma.j.issn.1673-4114.2018.03.006
摘要:
目的 分析病理分期为ⅢA-N2（pⅢA-N2）的非小细胞肺癌（NSCLC）患者行手术+辅助化疗后，加或不加术后放疗（PORT）的疗效，从术前临床因素中筛选能从PORT中获益的亚组人群。方法 回顾性分析2006年1月至2015年12月行根治性手术的pⅢA-N2 NSCLC患者804例。其中，PORT组患者276例，单纯化疗组528例。通过增强CT或者PET/CT获取准确的临床淋巴结分期。CT上淋巴结短径≥10 mm或者PET/CT上淋巴结SUV>2.5定义为转移淋巴结。PORT使用三维适形或调强放疗技术，计划靶体积的设计处方剂量为50~60 Gy，剂量分割为1.8～2.2 Gy/次。采用Log Rank法进行单因素预后分析，Cox回归进行多因素预后分析及亚组分析，通过Kaplan-Meier法和Log Rank检验评估PORT对总生存（OS）、无病生存（DFS）、无局部区域复发生存（LRFS）和无远处转移生存（DMFS）的影响，并进行亚组分析。结果 全组患者的中位随访时间为32.07个月。2年、5年OS分别为82.1%、54.5%，中位DFS为19.84个月，中位LRFS为120.31个月，中位DMFS为30.52个月。行PORT显著改善了OS（χ2=5.253，P=0.022）、DFS（χ2=18.397，P<0.001）、LRFS（χ2=15.358，P<0.001）和DMFS（χ2=6.434，P=0.011），且差异均有统计学意义。单因素分析结果显示，男性、年龄≥60岁、术前T分期增加、术前N分期为N1~N2、病理类型为非鳞癌非腺癌、化疗周期为1~2、未行PORT是显著影响OS的不良预后因素。多因素分析结果显示性别、年龄、术前N分期、病理类型、是否PORT为OS相关的独立预后因素；行PORT有OS获益的亚组分别为男性（HR：0.697，95% CI：0.513~0.947，P=0.021）、吸烟（HR：0.648， 95% CI：0.464~0.905，P=0.011）、术前N分期为N1~N2（HR：0.640，95% CI：0.465~0.881，P=0.006）、临床分期为Ⅲ期（HR：0.688，95% CI：0.484~0.980，P=0.038）以及病理类型为腺癌（HR：0.726，95% CI：0.527~0.999，P=0.049）的患者。结论 PORT能改善全组患者的OS、DFS、LRFS和DMFS。部分术前临床因素具有预测PORT后有OS获益的亚组人群的价值，包括男性、吸烟、术前N分期为N1~N2、临床分期为Ⅲ期以及病理类型为腺癌的患者。
Abstract:
Objective Pathological ⅢA-N2 non-small-cell lung cancer (pⅢA-N2 NSCLC) is a heterogeneous population, and the role of postoperative radiotherapy(PORT) after the adjuvant chemotherapy (ACT) in pⅢA-N2 NSCLC remains ambiguous. Not all pⅢA-N2 patients can benefit from PORT. This study was performed to identify the subgroup that can benefit from PORT after ACT. Methods This study included 804 pⅢA-N2 NSCLC patients completing radical resection and ACT from January 2006 to December 2015. The patients were divided into two groups:PORT group, patients who underwent PORT after radical resection and ACT; and NON-PORT group, control group of patients who only underwent radical resection and ACT. The PORT and NON-PORT groups consisted of 276 and 528 patients, respectively. Accurate clinical lymph node staging was obtained through contrast-enhanced CT and/or PET/CT. Lymph nodes measured in the short axis ≥ 10 mm on CT or SUV>2.5 on PET/CT were considered as metastases. Using 3-dimensional conformal radiation therapy or intensity modulated radiation therapy techniques, PORT was administered at 1.8-2.2 Gy per fraction to a prescription dose to the planning target volume of 50-60 Gy. Outcome measures included overall survival(OS), disease-free survival(DFS), locoregional recurrence-free survival(LRFS), and distant metastasis-free survival(DMFS). Kaplan-Meier, Log Rank test, and Cox regression were used to analyze survival data and identify prognostic factors. Statistically significant difference was set to P<0.05. Results Median follow-up time was 32.07 months. The 2-year and 5-year OS of the patients in the entire cohort were 82.1% and 54.5%, respectively. The median values of the DFS, LRFS, and DMFS were 19.84, 120.31, and 30.52 months, respectively. In the overall study cohort, the median values of the OS(97.31 months vs. 64.10 months, χ2=5.253, P=0.022), DFS (25.76 months vs. 17.97 months, χ2=18.397, P<0.001), LRFS(120.31 months vs. 101.03 months, χ2=15.358, P<0.001) and DMFS(36.83 months vs. 28.49 months, χ2=6.434, P=0.011) were significantly higher in the PORT group than in the NON-PORT group. Univariate analysis showed that the adverse prognostic factors which significantly affected OS were:male, age ≥ 60 years, advanced preoperative T staging, preoperative N1-N2, non-squamous carcinoma and non-adenocarcinoma, 1-2 chemotherapy cycles and NON-PORT. Multivariate Cox analyses revealed that factors independently associated with longer OS were PORT(HR=0.754, 95%CI=0.584-0.973, P=0.03), female, age <60 years, preoperative clinical N0, clinic stage Ⅰ-Ⅱ, adenocarcinoma, or squamous carcinoma. Subgroup analysis indicated that several preoperative clinical factors could predict the population that would benefit from PORT after ACT. These factors included male(HR=0.697, 95%CI=0.513-0.947, P=0.021), smoking patient(HR=0.648, 95%CI=0.464-0.905, P=0.011), preoperative clinical N1-N2(HR=0.640, 95%CI=0.465-0.881, P=0.006), clinic stage Ⅲ(HR=0.688, 95%CI=0.484-0.980, P=0.038), and adenocarcinoma(HR=0.726, 95%CI=0.527-0.999, P=0.049). Conclusions PORT after ACT could significantly improve the 5-year OS, DFS, LRFS, and DMFS in pⅢA-N2 NSCLC patients. Moreover, PORT could improve the 5-year OS of the subgroups with the following characteristics:male, smoking patient, preoperative clinical N1-N2, clinic stage Ⅲ, and adenocarcinoma.

参考文献/References:

[1] Reck M, Heigener DF, Mok T, et al. Management of non-small-cell lung cancer: recent developments[J]. Lancet, 2013, 382(9893):709-719. DOI:10.1016/S0140-6736(13)61502-0.
[2] Arriagada R, Dunant A, Pignon JP, et al. Long-term results of the international adjuvant lung cancer trial evaluating adjuvant Cisplatin-based chemotherapy in resected lung cancer[J]. J Clin Oncol, 2010, 28(1):35-42. DOI:10.1200/JCO.2009.23.2272.
[3] NSCLC Meta-analyses Collaborative Group, Arriagada R, Auperin A, et al. Adjuvant chemotherapy, with or without postoperative radiotherapy, in operable non-small-cell lung cancer: two meta-analyses of individual patient data[J]. Lancet, 2010, 375(9722):1267-1277. DOI:10.1016/S0140-6736(10)60059-1.
[4] Le PC. Role of postoperative radiotherapy in resected non-small cell lung cancer:a reassessment based on new data[J]. Oncologist, 2011, 16(5):672-681. DOI:10.1634/theoncologist. 2010-0150.
[5] Winton T, Livingston R, Johnson D, et al. Vinorelbine plus cisplatin vs. observation in resected non-small-cell lung cancer[J]. N Engl J Med, 2005, 352(25):2589-2597. DOI:10.1056/NEJMoa043623.
[6] Belkacémi Y, Azria D. New tools in adjuvant breast cancer radiotherapy[J]. Bull Cancer, 2007, 94(4):389-397. DOI:10.1684/bdc.2007.0230.
[7] Ramsey S, Tepper JE. Rectal cancer radiotherapy[J]. Cancer J, 2007, 13(3):204-209. DOI:10.1097/PPO.0b013e318074def2.
[8] PORT Meta-analysis Trialists Group. Postoperative radiotherapy in non-small-cell lung cancer:systematic review and meta-analysis of individual patient data from nine randomised controlled trials[J]. Lancet, 1998, 352(9124):257-263. DOI:10.1016/S0140-6736(98)06341-7.
[9] Lally BE, Zelterman D, Colasanto JM, et al. Postoperative radiotherapy for stage Ⅱ or Ⅲ non-small-cell lung cancer using the surveillance, epidemiology, and end results database[J]. J Clin Oncol, 2006, 24(19):2998-3006. DOI:10.1200/JCO.2005.04.6110.
[10] Douillard JY, Rosell R, De Lena M, et al. Adjuvant vinorelbine plus cisplatin versus observation in patients with completely resected stage IB-ⅢA non-small-cell lung cancer (Adjuvant Navelbine International Trialist Association[ANITA]): a randomised controlled trial[J]. Lancet Oncol, 2006, 7(9):719-727. DOI:10.1016/S1470-2045(06)70804-X.
[11] Dai H, Hui Z, Ji W, et al. Postoperative radiotherapy for resected pathological stage ⅢA-N2 non-small cell lung cancer: a retrospective study of 221 cases from a single institution[J]. Oncologist, 2011, 16(5):641-650. DOI:10.1634/theoncologist.2010-0343.
[12] Perry MC, Kohman LJ, Bonner JA, et al. A phase Ⅲ study of surgical resection and paclitaxel/carboplatin chemotherapy with or without adjuvant radiation therapy for resected stage Ⅲ non-small-cell lung cancer:Cancer and Leukemia Group B 9734[J]. Clin Lung Cancer, 2007, 8(4):268-272. DOI:10.3816/CLC.2007.n.005.
[13] Patel SH, Ma Y, Wernicke AG, et al. Evidence supporting contemporary post-operative radiation therapy(PORT) using linear accelerators in N2 lung cancer[J]. Lung Cancer, 2014, 84(2):156-160. DOI:10.1016/j.lungcan.2014.02.016.
[14] Billiet C, Decaluwé H, Peeters S, et al. Modern post-operative radiotherapy for stage Ⅲ non-small cell lung cancer may improve local control and survival: a meta-analysis[J]. Radiother Oncol, 2014, 110(1):3-8. DOI:10.1016/j.radonc.2013.08.011.
[15] Sawyer TE, Bonner JA, Gould PM, et al. Effectiveness of postoperative irradiation in stage ⅢA non-small cell lung cancer according to regression tree analyses of recurrence risks[J]. Ann Thorac Surg, 1997, 64(5):1402-1407. DOI:10.1016/S0003-4975(97)00908-9.
[16] Matsuguma H, Nakahara R, Ishikawa Y, et al. Postoperative radiotherapy for patients with completely resected pathological stage ⅢA-N2 non-small cell lung cancer:focusing on an effect of the number of mediastinal lymph node stations involved[J]. Interact Cardiovasc Thorac Surg, 2008, 7(4):573-577. DOI:10.1510/icvts.2007. 174342.
[17] Hui Z, Dai H, Liang J, et al. Selection of proper candidates with resected pathological stage ⅢA-N2 non-small cell lung cancer for postoperative radiotherapy[J]. Thorac Cancer, 2015, 6(3):346-353. DOI:10.1111/1759-7714.12186.
[18] McGovern SL, Liao Z, Bucci MK, et al. Is sex associated with the outcome of patients treated with radiation for non-small cell lung cancer?[J]. Cancer, 2009, 115(14):3233-3242. DOI:10.1002/cncr.24361.
[19] Vogelius IR, Bentzen SM. A literature-based meta-analysis of clinical risk factors for development of radiation induced pneumonitis[J]. Acta Oncol, 2012, 51(8):975-983. DOI:10.3109/0284186X.2012. 718093.
[20] Ruckdeschel JC. Combined modality therapy of non-small cell lung cancer[J]. Semin Oncol, 1997, 24(4):429-439.
[21] Robinson LA, Wagner H, Ruckdeschel JC. Treatment of stage ⅢA non-small cell lung cancer[J]. Chest, 2003, 123(1 Suppl):202S-220S. DOI:10.1378/chest.123.1_suppl.2023.
[22] Yoshino I, Yoshida S, Miyaoka E, et al. Surgical outcome of stage ⅢA-cN2/pN2 non-small-cell lung cancer patients in Japanese lung cancer registry study in 2004[J]. J Thorac Oncol, 2012, 7(5):850-855. DOI:10.1097/JTO.0b013e31824c945b.
[23] Asamura H, Goya T, Koshiishi Y, et al. A Japanese Lung Cancer Registry study: prognosis of 13,010 resected lung cancers[J]. J Thorac Oncol, 2008, 3(1):46-52. DOI:10.1097/JTO.0b013e31815 e8577.

相似文献/References:

[1]李景涛,邓垒,张文珏,等.广泛期小细胞肺癌胸部IMRT后发生放射性肺炎的危险因素分析[J].国际放射医学核医学杂志,2016,40(2):100.[doi:10.3760/cma.j.issn.1673-4114.2016.02.003]
　Li Jingtao,Deng Lei,Zhang Wenjue,et al.Risk factor analysis for predicting radiation pneumonitis in extensive stage small cell lung cancer patients receiving IMRT thoracic radiotherapy[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(3):100.[doi:10.3760/cma.j.issn.1673-4114.2016.02.003]
[2]万绪明,许祖闪,侯红军.磁共振表观弥散系数变化率对肝细胞肝癌患者单次TACE术后疗效评价的应用价值[J].国际放射医学核医学杂志,2015,39(2):129.[doi:10.3760/cma.j.issn.1673-4114.2015.02.006]
　Wan Xuming,Xu Zushan,Hou Hongjun.Applieation value of the change ratio of apparent diffusion coefficient in the therapeutic evaluation of hepatocellular carcinoma treated by single transcatheter arterial chemoembolization[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(3):129.[doi:10.3760/cma.j.issn.1673-4114.2015.02.006]
[3]王振光,王洋洋.PET/CT显像在肝细胞肝癌诊断中的研究进展[J].国际放射医学核医学杂志,2015,39(2):175.[doi:10.3760/cma.j.issn.1673-4114.2015.02.016]
　Wang Zhenguang,Wang Yangyang.The development of PET/CT imaging in the diagnosis of hepatocellular carcinoma[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(3):175.[doi:10.3760/cma.j.issn.1673-4114.2015.02.016]
[4]李欢欢,李素平,游金辉.小细胞肺癌伴副肿瘤综合征患者骨显像示肌肉摄取一例[J].国际放射医学核医学杂志,2014,38(2):140.[doi:10.3760/cma.j.issn.1673-4114.2014.02.016]
[5]龙再颖,汤春静,于立明,等.甲状腺乳头状癌术后刺激状态Tg与颈部淋巴结转移关系的研究[J].国际放射医学核医学杂志,2013,37(1):27.[doi:10.3760/cma.j.issn.1673-4114.2013.01.008]
　LONG Zai-ying,TANG Chun-jing,YU Li-ming,et al.The correlation between the stimulated thyroglobulin level after surgery in papillary thyroid carcinoma and cervical lymph node metastasis[J].International Journal of Radiation Medicine and Nuclear Medicine,2013,37(3):27.[doi:10.3760/cma.j.issn.1673-4114.2013.01.008]
[6]张一秋,石洪成.肝细胞癌肿瘤新生血管影像学评价的研究进展[J].国际放射医学核医学杂志,2013,37(1):60.[doi:10.3760/cma.j.issn.1673-4114.2013.01.015]
　ZHANG Yi-qiu,SHI Hong-cheng.Advances in assessment of imaging examination for tumor neoangiogenesis induced by hepatocellular carcinoma[J].International Journal of Radiation Medicine and Nuclear Medicine,2013,37(3):60.[doi:10.3760/cma.j.issn.1673-4114.2013.01.015]
[7]任凌,戴皓洁.125Ⅰ粒子在头颈部腺样囊性癌综合治疗中的作用[J].国际放射医学核医学杂志,2011,35(1):13.[doi:10.3760/cma.j.issn.1673-4114.2011.01.004]
　REN Ling,DAI Hao-jie.The effect of 125I seed in comprehensive therapy of the head and neck adenoid cystic carcinoma[J].International Journal of Radiation Medicine and Nuclear Medicine,2011,35(3):13.[doi:10.3760/cma.j.issn.1673-4114.2011.01.004]
[8]李红兵,陈勇,曾建国,等.肝动脉化疗性栓塞结合Ⅱ期手术切除治疗巨块型外生型肝癌[J].国际放射医学核医学杂志,2010,34(1):49.[doi:10.3760/cma.j.issn.1673-4114.2010.01.013]
　LI Hong-bing,CHEN Yong,ZENG Jian-guo,et al.Treatment of massive extrahepatic growing hepatocellular carcinoma with TACE in combination with secondary resection[J].International Journal of Radiation Medicine and Nuclear Medicine,2010,34(3):49.[doi:10.3760/cma.j.issn.1673-4114.2010.01.013]
[9]付晓昉,王秀梅,许建春.放射性榄香烯三羰基铼配合物在荷小细胞肺癌裸鼠体内的分布及其对肿瘤的生长抑制作用[J].国际放射医学核医学杂志,2009,33(6):335.[doi:10.3760/cma.j.issn.1673-4114.2009.06.004]
　FU Xiao-fang,WANG Xiu-mei,XU Jian-chun.Anti-tumor effect of elemene tricarbonyl rhenium-188 complex to small cell lung cancer and its biodistribution in nude mice[J].International Journal of Radiation Medicine and Nuclear Medicine,2009,33(3):335.[doi:10.3760/cma.j.issn.1673-4114.2009.06.004]
[10]郑磊,李前伟.18F-氟脱氧葡萄糖PET在原发陛肝细胞癌中的应用[J].国际放射医学核医学杂志,2008,32(1):23.
　ZHENG Lei,LI Qian-wei.Application of positron emission tomography with 18F-fluorodeoxyglucose in hepatocellular carcinoma[J].International Journal of Radiation Medicine and Nuclear Medicine,2008,32(3):23.
[11]张毓艺,姚稚明.18F-FDG PET/CT对非小细胞肺癌淋巴结分期诊断价值的研究进展[J].国际放射医学核医学杂志,2016,40(6):447.[doi:10.3760/cma.j.issn.1673-4114.2016.06.009]
　Zhang Yuyi,Yao Zhiming.The progress of 18F-FDG PET/CT in the diagnosis of N-staging of non-small cell lung cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(3):447.[doi:10.3760/cma.j.issn.1673-4114.2016.06.009]
[12]戈畅,梁硕.化疗联合DC-CIK生物治疗非小细胞肺癌的临床价值及CT灌注成像的疗效评价[J].国际放射医学核医学杂志,2014,38(6):377.[doi:10.3760/cma.j.issn.1673-4114.2014.06.007]
　Ge Chang,Liang Shuo.The clinical value and CT perfusion evaluation in chemotherapy combined with DC-CIK biological treatment of non-small cell lung cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2014,38(3):377.[doi:10.3760/cma.j.issn.1673-4114.2014.06.007]
[13]黄少祥,樊体强.塞来昔布对非小细胞肺癌移植瘤的辐射增敏实验研究[J].国际放射医学核医学杂志,2013,37(3):150.[doi:10.3760/cma.j.issn.1673-4114.2013.03.006]
　HUANG Shao-xiang,FAN Ti-qiang.Radiosensitization on non-small cell lung cancer induced by celecoxib[J].International Journal of Radiation Medicine and Nuclear Medicine,2013,37(3):150.[doi:10.3760/cma.j.issn.1673-4114.2013.03.006]
[14]于丽娟,李迎辞,王文志,等.PET-CT及PET-CT结合Lung VCAR软件对非小细胞肺癌肺门区淋巴结的诊断分析[J].国际放射医学核医学杂志,2012,36(6):323.[doi:10.3760/cma.j.issn.1673-4114.2012.06.002]
　YU Li-juan,LI Ying-ci,WANG Wen-zhi,et al.Value of PET-CT and PET-CT combined with Lung VCAR software in the diagnosis of hilar area lymph nodes of non-small cell lung cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2012,36(3):323.[doi:10.3760/cma.j.issn.1673-4114.2012.06.002]
[15]刘莉,杨景魁.125I粒子植入治疗非小细胞肺癌的护理及辐射防护[J].国际放射医学核医学杂志,2012,36(3):172.[doi:10.3760/cma.j.issn.1673-4114.2012.03.013]
　LIU Li,YANG Jing-kui.Radiation protective nursing intervene of 125I seed implantation in non-small cell lung cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2012,36(3):172.[doi:10.3760/cma.j.issn.1673-4114.2012.03.013]
[16]梁吉祥,柴树德,郑广钧,等.CT引导下植入125I粒子治疗非小细胞肺癌切除术后局部复发的疗效[J].国际放射医学核医学杂志,2011,35(3):181.[doi:10.3760/cma.j.issn.1673-4114.2011.03.012]
　LIANG Ji-xiang,CHAI Shu-de,ZHENG Guang-jun,et al.CT-guided percutaneous interstitial implantation of 125I for recurrent patients of postoperative non-small cell lung carcinoma[J].International Journal of Radiation Medicine and Nuclear Medicine,2011,35(3):181.[doi:10.3760/cma.j.issn.1673-4114.2011.03.012]
[17]吴红宇,贺晓东,刘宇,等.呼吸门控放疗非小细胞肺癌[J].国际放射医学核医学杂志,2011,35(5):314.[doi:10.3760/cma.j.issn.1673-4114.2011.05.015]
　WU Hong-yu,HE Xiao-dong,LIU Yu,et al.Respiratory gated radiotherapy for non-small cell lung cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2011,35(3):314.[doi:10.3760/cma.j.issn.1673-4114.2011.05.015]
[18]陆光兵,刘丽.125I粒子联合EP方案治疗局部晚期非小细胞肺癌的临床分析[J].国际放射医学核医学杂志,2010,34(2):105.[doi:10.3760/cma.j.issn.1673-4114.2010.02.012]
[19]鲁胜男,冯彦林.18F-FDG PET-CT在评价肺癌化疗疗效中的应用[J].国际放射医学核医学杂志,2010,34(3):164.
　LU Sheng-nan,FENG Yan-lin.The application of 18F-FDG PET-CT in evaluation of the value of lung cancer chemotherapy[J].International Journal of Radiation Medicine and Nuclear Medicine,2010,34(3):164.
[20]姚立新,付占昭,顾涛,等.99Tcm-甲氧基异丁基异腈SPECT评价非小细胞肺癌化疗疗效[J].国际放射医学核医学杂志,2009,33(5):272.[doi:10.3760/cnla.j.issn.1673-4114.2009.05.005]
　YAO Li-xin,FU Zhan-zhao,GU Tao,et al.99Tcm-methoxyisobutylisonitrile SPECT imaging evaluate chemotherapy of non-small cell lung cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2009,33(3):272.[doi:10.3760/cnla.j.issn.1673-4114.2009.05.005]

备注/Memo

备注/Memo:
收稿日期:2018-03-27。
基金项目:国家重大研发计划（2016YFC0904600、2017YFC1311000）；首都临床特色应用研究（Z171100001017114）；中国医学科学院医学与健康科技创新工程项目（2016-I2M-1-011）；北京希望马拉松专项基金联合攻关课题（LC2016L03）
通讯作者:惠周光,Email:drhuizg@163.com
更新日期/Last Update: 2018-05-25