Evaluation of the impact of integrated [18f]-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography imaging on staging and radiotherapy treatment volume definition of nonsmall cell lung cancer
The aim of this study was to evaluate the impact of integrated positron emission tomography (PET)/computed tomography (CT) imaging on staging and radiotherapy treatment volume definition of non-small cell lung cancer (NSCLC). Thirty-nine patients with NSCLC referred to the Department of Radiation Oncology of Gulhane Military Medical Academy, for radical radiotherapy between June 2011 and December 2011 were enrolled in this study. All patients underwent integrated PET/CT imaging in treatment position for initial assessment. For patients deemed suitable for radical radiotherapy, CTbased and integrated PET/CT imaging based radiotherapy treatment plans were generated to comparatively evaluate dose-volume parameters of both plans. Of the 39 patients initially assessed with integrated PET/CT imaging, 29 patients (74.4%) were deemed suitable for radical radiotherapy with curative intent. Fifteen patients (38.5%) were upstaged after integrated PET/CT staging. Of the 29 patients treated with radical radiotherapy at our department using integrated PET/CT imaging based radiation treatment planning (RTP), gross tumor volume was decreased in 16 patients (55.2%) and increased in 13 patients (44.8%) by incorporating PET/CT into RTP. Integrated PET/CT imaging allows selection of patients eligible for radical radiotherapy along with tailoring of radiotherapy target volumes to prevent overtreatment and undertreatment.Key words: Non-small cell lung cancer, positron emission tomography, radiotherapy, treatment planningEntegre [18f]-fluoro-2-deoksi-D-glikoz (FDG) pozitron emisyon tomografi/bilgisayarl tomografi grntlemesinin kk hcreli d akcier kanseri evreleme ve radyoterapi tedavi hacim tanmlamasna etkisinin deerlendirilmesizetBu almann amac entegre pozitron emisyon tomografi (PET)/bilgisayarl tomografi (BT) grntlemesinin kk hcreli d akcier kanseri (KHDAK) evrelemesi ve tedavi hacmi tanmlamasna etkisinin deerlendirilmesidir. Haziran 2011 ile Aralk 2011 arasnda KHDAK tansyla Glhane Askeri Tp Akademisi (GATA) Radyasyon Onkolojisi Anabilim Dal’na ynlendirilen 39 hasta almaya dahil edilmitir. Balang deerlendirmesi iin tm hastalara tedavi pozisyonunda entegre PET/BT grntlemesi yaplmtr. Radikal radyoterapi iin uygun olduu deerlendirilen hastalara BT tabanl ve entegre PET/BT grntlemesi tabanl iki ayr planlama, doz-hacim parametrelerinin bu iki planlamada karlatrlmas iin yaplmtr. Entegre PET/BT grntlemesiyle balang deerlendirmesi yaplan 39 hastadan 29’u (%74.4) kratif amal radikal radyoterapi iin uygun olarak deerlendirilmitir. Entegre PET/BT grntlemesi sonras 15 hastada (%38.5) evre atlamas grlmtr. PET/BT’nin radyoterapi planlamasna dahil edilmesiyle kliniimizde entegre PET/BT grntlemesi tabanl radyoterapi planlamas kullanlarak tedavi edilen 29 hastadan 16’snda (%55.2) gros tmr hacmi azalm, 13 hastada (%44.8) ise artmtr. Entegre PET/BT grntlemesi, fazla ve eksik tedavinin engellenmesi iin radikal radyoterapiye uygun hastalarn seimiyle birlikte radyoterapi hedef hacimlerinin ekillendirilmesine imkan salar.Anahtar Kelimeler: Kk hcreli d akcier kanseri, pozitron emisyon tomografi, radyoterapi, tedavi planlamas