目的：对18F-FDG PET/CT评价TOMO刀治疗胰腺癌疗效的价值进行初步探讨。方法入组26例TOMO刀治疗的胰腺癌患者，研究治疗前后两次成像病灶的标准摄取值的最大值（ SUVmax ）及平均值（SUVmean）、PET／CT显示肿瘤大小、KPS评分、疼痛缓解等指标的变化。结果 TOMO刀治疗前后，SUVmax分别为（3.35±1.84）和（1.71±0.69）（t=4.235，P=0.000），SUVmean分别为（2.02±0.98）和（1.23±0.38）（t=3.571，P=0.002），肿瘤大小分别为（7.18±10.01）cm2和（3.18±4.54）cm2（t=2.640，P=0.014），KPS评分分别为（79.23±4.40）和（83.83±9.41）（t=3.207，P=0.004），差异均具有统计学意义（P＜0.05）。21例有疼痛症状的患者均有不同程度的疼痛缓解；但其中16例（16/26，61.5%）新发淋巴结转移和（或）肝、肺转移，以及腹膜种植转移，整体病情出现进展。结论18F-FDG PET/CT为评价TOMO刀治疗胰腺癌疗效提供了一种可行的无创性检查方法，TOMO刀治疗对胰腺癌局部病灶有效，可显著减轻患者的疼痛，改善KPS评分，但对整体病情的控制欠佳。%Objective To evaluate the effects of TOMO therapy in patients with pancreatic cancer using 18F-FDG PET/CT imaging. Method The changes of SUVmax, SUVmean, tumor size on PET/CT, KPS score and pain relief in 26 patients with pancreatic cancer before and after TOMO therapy were investigated. Result Compared as before vs af-ter TOMO therapy, SUVmax were (3.35 ± 1.84) vs (1.71 ± 0.69) (t = 4.235, P = 0.000), SUVmean were (2.02 ± 0.98) vs (1.23 ± 0.38), (t = 3.571, P = 0.002), tumor size on PET/CT were (7.18 ± 10.01) cm2 vs (3.18 ± 4.54) cm2 ( t = 2.640, P = 0.014), KPS scores were (79.23±4.40) vs (83.83±9.41) (t = 3.207, P = 0.004), suggesting significant differences of those measurements before and after TOMO therapy (P< 0.05). Twenty-one patients experienced pain relief to var-ied degrees, while there were 16 cases in 26 (61.5%) had been diagnosed with new lymph node metastasis and/ or liver, lung metastasis, peritoneal metastasis, revealing an overall progress of the disease in this cohort. Conclusion 18F-FDG PET/CT imaging can be used as a noninvasive and effective method for evaluation of TOMO therapy effect in patients with pancreatic cancer. TOMO therapy is effective for localized disease, which helps reduce pain and im-prove the KPS score, but it is of little value in controlling overall condition.
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