[Application of perfusion CT scan in assessing the treatment and predicting prognosis for lung cancer before and after chemotherapy/radiotherapy].
OBJECTIVE
This study is to evaluate the changes in tumor perfusion CT before and after chemotherapy/radiotherapy, and its feasibility in assessing early treatment response and predicting the prognosis in lung cancer patients.


METHODS
Perfusion CT scan was performed on a multidetector CT scanner with power injection of contrast medium (50 ml, 300 mg I/ml, 4 ml/s) in the patients before and after chemotherapy/radiotherapy. The treatment response after chemotherapy/radiotherapy was assessed by RECIST. The correlation of pre- and post-treatment tumor perfusion changes with progression-free survival (PFS) and overall survival (OS) was analyzed.


RESULTS
The patients were divided into two groups according to PS changs. In the increased PS group (n = 13), the PS after treatment was significantly higher than that before treatment (20.1 +/- 7.5 ml x min(-1) x 100 g(-1) vs. 13.7 +/- 6.2 ml/min/100 g, P = 0.013), while in the decreased PS group (n = 11), the PS after treatment was significantly lower than that before treatment (8.2 +/- 5.5 ml x min (-1) x 100 g(-1) vs. 15.3 +/- 5.1 ml x min(-1) x 100 g(-1), P = 0.000). No significant differences were observed in BF, BV, and MTT in both groups. The median PFS of PS increased group and decreased groups was 4.2 months and 19.0 months, respectively, (P = 0.000), and the median OS was 7.9 months and 19.3 months, respectively (P = 0.002).


CONCLUSIONS
Perfusion CT may have a potential application in predicting the prognosis of lung cancer after chemotherapy/radiotherapy, and PS increase after treatment may indicate a poor survival.
Wang
Jian-wei
JW
Department of Diagnostic Radiology, Cancer Hospital (Institute), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Wu
Ning
N
Song
Ying
Y
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000532:radiotherapy; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018288:Carcinoma, Small Cell / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000532:radiotherapy; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000532:radiotherapy; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D055420:Perfusion Imaging / Q000379:methods*; D011446:Prospective Studies; D011882:Radiotherapy, High-Energy; D015996:Survival Rate; D036542:Tomography, Spiral Computed / Q000379:methods*; D016896:Treatment Outcome; D047368:Tumor Burden