摘要目的 分析PET-CT在多发性骨髓瘤(MM)疗效评估中的作用.方法 对55例MM患者予以3个疗程CTD方案(环磷酰胺、沙利度胺、地塞米松)化疗,治疗前及治疗后均完善血液学检查,并行PET-CT检查,测量脊柱、骨盆、肋骨的最大标准摄取值(SUVmax),每个患者取其平均SUVmax.对疾病疗效进行评价的同时观察SUV变化.结果 24例患者经治疗后疾病达完全缓解(CR),SUV值下降[(3.82±0.83)比(2.05±0.49),t=9.045,P＜0.001]; 11例达非常好的部分缓解(VGPR),SUV值下降[(4.77±1.13)比(3.29±0.49),t=3.998,P=0.001];9例达部分缓解(PR),SUV值略下降[(5.36±0.47)比(4.97±0.40),t=1.886,P＞0.05],8例达稳定(SD),SUV值无明显改变[(6.40±0.96)比(5.63±0.69),t=1.819,P＞0.05],3例疾病进展(PD),SUV值较前升高[(6.57±0.72)比(7.53±4.69),t=-0.353,P＞ 0.05].其中对24例达CR的患者随访12个月,治疗后SUV值仍高的患者其无进展生存期短(部分患者仅维持4个月).结论 PET-CT对MM的疗效评价具有重要价值,有助于临床早期判断疗效,制定个体化治疗方案.

abstractsObjective To investigate the role of PET-CT in evaluating the response to the treatment in patients with multiple myeloma.Methods 55 newly diagnosed multiple myeloma patients were collected.Patients were provided with 3 CTD chemotherapy,complete blood examination before and after treatment,parallel PET-CT,and measuring the spine,pelvis,rib SUVmax,each with an average of the SUVmax.The curative effect observated in SUV changes and disease were evaluated.Results In 24 patients after treatment,CR,SUV values were significantly decreased [(3.82±0.83) vs (2.05±0.49),t=9.045,P ＜ 0.001].11 cases of VGPR,SUV values were decreased [(4.77±1.13) vs (3.29±0.49),t =3.998,P =0.001].9 cases of PR,SUV values were slightly decreased [(5.36±0.47) vs (4.97±0.40),t =1.886,P ＞ 0.05],in 8 cases of SD,the SUV values had no obvious change [(6.40±0.96) vs (5.63±0.69),t =1.819,P ＞ 0.05],in 3 cases of disease progression we had higher SUV values from the previous [(6.57±0.72) vs (7.53±4.69),t =-0.353,P ＞ 0.05].CR of 24 cases were followed up for 12 months,SUV values were still high in patients after treatment of the short progression-free survival (PFS) (Some patients only lasted 4 months).Conclusion PET-CT has important value in the evaluation of therapeutic effect of multiple myeloma,it helps to determine the early clinical efficacy,and to plan individualized treatment.