Zusammenfassung
Die Fusion anatomischer und funktioneller Daten stellt für die Bestrahlungsplanung nichtkleinzelliger Bronchialkarzinome einen großen Fortschritt dar. Damit ist es möglich, bei Patienten mit bisher nicht detektierten Fernmetastasen toxische Therapiestrategien zu vermeiden und Kosten zu sparen. Für die Anwendung neoadjuvanter Therapiekonzepte kann mittels der funktionellen Daten schon während der Therapie eine Aussage über das Ansprechen des Tumors und den Benefit für den Patienten getroffen werden. Die Implementierung der PET-CT in die Bestrahlungsplanung führt zu einer exakteren Zielvolumendefinition durch bessere Detektion vorhandener mediastinaler Lymphknotenmetastasen, die verbesserte Abgrenzbarkeit des Primärtumors und die Unterscheidung von Tumor und Atelektase sowie einer Verminderung der Interobserver-Variabilität in der Festlegung des Zielvolumens. Ob diese Verbesserungen sich in eine verbesserte lokale Kontrolle umsetzen lassen, muss in weiteren Untersuchungen gezeigt werden.
Abstract
The fusion of anatomical and functional data is a major advance in the planning of radiation therapy for non-small cell lung cancer. It is thus possible to avoid toxic therapy strategies in patients with previously undetected distant metastases and to reduce costs. For the use of neoadjuvant therapy concepts, evidence of influence on the tumor and benefit for the patient can already be determined from the functional data during therapy. Implementation of the PET-CT in radiotherapy planning leads to an exact target volume definition via the better detection of existing mediastinal lymph node metastases, the improved demarcation of the primary tumor, and the differentiation between tumor and atelectasis, as well as a reduction in intra-observer variation in defining the target volume. Whether these improvements will also allow improved local control must be determined in future studies.
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Marnitz, S., Messer, P., Stuschke, M. et al. Einsatz der PET-CT zur Verbesserung der Bestrahlungsplanung nichtkleinzelliger Bronchialkarzinome. Onkologe 11, 859–865 (2005). https://doi.org/10.1007/s00761-005-0914-5
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DOI: https://doi.org/10.1007/s00761-005-0914-5