PET-CT nozīme krūts vēža stadijas precizēšanā
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Date
2022
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Latvijā katru gadu ⅓ no jaunatklātajiem krūts vēža gadījumiem ir vēlā stadijā, kas apgrūtina ārstēšanas iespējas. Krūts vēža pacientu ārstēšana un prognoze ir pārsvarā atkarīga no slimības anatomiskās izplatības. Darba mērķis bija retrospektīvi novērtēt fluor-18 fluorodeoksiglikozes pozitronu emisijas datortomogrāfijas (18F-FDG PET/DT) spējas diagnosticēt ļaundabīgas pārmaiņas ārpus primārā audzēja, kā arī šo rezultātu ietekmi uz krūts vēža klīnisko stadiju un veicinātās izmaiņas terapijā. No Paula Stradiņa Klīniskās Universitātes slimnīcas Krūts slimību centra pacientu reģistra tika atlasītas 30 krūts vēža pacientes, kuras ārstēšanas laikā tika nosūtītas veikt PET/DT izmeklējumu ambulatori. Interesējošie parametri tika iegūti izmantojot klīniskajās informācijas sistēmās ‘’Ārsta Birojs’’ un ‘’DataMed’’ pieejamo medicīnisko informāciju par katru pacientu. Iegūtie dati tika salīdzināti savā starpā pirms un pēc PET/DT izmklējuma. Pētījuma rezultāti uzrādīja vēža stadijas maiņu 53% gadījumu, 33% stadija tika mainīta uz augstāku, 20% gadījumos uz zemāku un 47% vēža stadija netika mainīta pēc PET/DT. No 30 pacientēm tikai septiņas nebija uzsākušas aktīvu vēža ārstēšanu ar ķīmijterapiju, apgrūtinot iespējas precīzi izvērtēt PET/DT nozīmi ārstēšanas plāna izmaiņās, 100% gadījumu pacientes uzsāka vai turpināja ķīmijterapiju pēc PET/DT. Iegūtie dati tika salīdzināti ar zinātnisko publikāciju rezultātiem par šo tēmu, kur terapija pēc PET/DT tika mainīta aptuveni ⅓ gadījumu no krūts vēža pacientiem. Lai sekmīgi izvērtētu PET/DT ietekmi uz terapijas maiņu nepieciešams veikt lielāku prospektīvu pētījumu. Spriežot pēc rezultātiem, PET/DT ir nozīmīgs palīgs attālu metastāžu un paduses limfmezglu ļaundabīgu pārmaiņu atklāšanai ar biopsiju apstiprinātiem krūts vēža pacientiem ar klīnisko stadiju vismaz II B.
In Latvia every year ⅓ of newly diagnosed breast cancers are in late stages which make the treatment complicated. Prognosis and management of patients with breast cancer mostly depend on the anatomical spread of the disease. The aim of this study was to retrospectively evaluate benefits of fluorine-18fluorodeoxyglucose positron emission computed tomography (18F-FDG PET/CT) in detecting malignant changes outside of the primary breast tumour and its impact on cancer clinical stage and the induced changes in management. Thirty female patients were selected from Pauls Stradiņs Clinical University hospital Centre of breast disease patient register that were referred to outpatient PET/CT examination during their treatment period. Parameters of interest were obtained using the medical information available at the clinical information systems ‘’Ārsta Birojs’’ and ‘’DataMed’’ for each patient. Acquired data was compared between before and after PET/CT. Research results showed that cancer clinical stage was changed in 53% of total cases with escalation to more advanced stage in 10 cases (33%) and deescalation in six (20%), in 14 cases (47%) stage did not change after PET/CT. From 30 patients only seven were not actively treated with chemotherapy, which made it difficult to evaluate PET/CT benefits in the change of therapy, 100% of patients received or continued to receive chemotherapy after PET/CT. Data was compared with the relevant scientific literature where changes in therapy after PET/CT was made in approximately ⅓ of breast cancer cases. In order to evaluate PET/CT benefits in the choice of therapy a larger prospective study should be conducted. According to results PET/CT is a valuable tool for detecting distant metastases and malignant changes in extra axillary lymph nodes for biopsy-confirmed breast cancer patients starting from clinical stage II B and above.
In Latvia every year ⅓ of newly diagnosed breast cancers are in late stages which make the treatment complicated. Prognosis and management of patients with breast cancer mostly depend on the anatomical spread of the disease. The aim of this study was to retrospectively evaluate benefits of fluorine-18fluorodeoxyglucose positron emission computed tomography (18F-FDG PET/CT) in detecting malignant changes outside of the primary breast tumour and its impact on cancer clinical stage and the induced changes in management. Thirty female patients were selected from Pauls Stradiņs Clinical University hospital Centre of breast disease patient register that were referred to outpatient PET/CT examination during their treatment period. Parameters of interest were obtained using the medical information available at the clinical information systems ‘’Ārsta Birojs’’ and ‘’DataMed’’ for each patient. Acquired data was compared between before and after PET/CT. Research results showed that cancer clinical stage was changed in 53% of total cases with escalation to more advanced stage in 10 cases (33%) and deescalation in six (20%), in 14 cases (47%) stage did not change after PET/CT. From 30 patients only seven were not actively treated with chemotherapy, which made it difficult to evaluate PET/CT benefits in the change of therapy, 100% of patients received or continued to receive chemotherapy after PET/CT. Data was compared with the relevant scientific literature where changes in therapy after PET/CT was made in approximately ⅓ of breast cancer cases. In order to evaluate PET/CT benefits in the choice of therapy a larger prospective study should be conducted. According to results PET/CT is a valuable tool for detecting distant metastases and malignant changes in extra axillary lymph nodes for biopsy-confirmed breast cancer patients starting from clinical stage II B and above.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Krūts vēzis, PET/DT, Nukleārā radioloģija, 18F-FDG PET/DT, Pozitronu emisijas datortomogrāfija, vēža saslimstība, krūšu veselība, PET/CT, 18F-FDG PET/CT, Breast cancer, Cancer burden, Positron emission computed tomography, nuclear radiology, PET/CT and breast cancer