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[objective]To study effect of cerebral blood perfusion and cognitive function of carotid artery stenting com-bined with medical therapy for patients with severe internal carotid stenosis.[Methods]124 patients with severe internal ca-rotid stenosis from June 2014 to June 2016 were divided into observed group and the treatment group,The treatment group given pure medical therapy,observation group given carotid artery stenting combined with medical therapy.One year follow-upr,cerebral blood flow perfusion,cognitive function,adverse events were compared between two groups.[Result]The ob-servation group rTTP,rMTT,rCBV,rCBF were significantly lower than treatment group(P<0.05,P<0.01);MMSE,MoCA score were significantly higher than treatment group(P<0.05);Vascular Occlusion,vascular restenosis,cerebral ischemic stroke,transient cerebral ischemia were significantly lower than treatment group(1.61% vs 11.29%,4.84% vs 19.35%, 1.61% vs 14.52%,4.84% vs 17.74,P<0.05).[Conclusion]Carotid artery stenting combined with medical therapy help to improve cerebral blood flow perfusion in patients with severe internal carotid stenosi,improve cognitive function,and pre-vent adverse events.
RESUMO
<p><b>OBJECTIVE</b>The primary aim of this prospective study was to use serial (18)F-FDG PET-CT imaging to evaluate the trend of the tumor's maximum standardized uptake value (SUVmax) during radiotherapy (RT) for patients with nasopharyngeal carcinoma (NPC), and to explore the possibility of early evaluation of the tumor bio-metabolic response during radiotherapy.</p><p><b>METHODS</b>Sixty patients with biopsy-proven primary NPC were prospectively enrolled into the study. All patients underwent four (18)F-FDG PET-CT scans: one initial scan before RT/cisplatin based concurrent chemoradiotherapy, at the point of 50 Gy during RT, the end of RT, and one month after RT, respectively. Tumor (18)F-FDG uptake was analyzed according to the World Health Organization pathological type.</p><p><b>RESULTS</b>There was a significant difference (P < 0.001) of the mean of SUVmax of the primary site among pretreatment (11.20 ± 5.37) and posttreatment at the dose of 50 Gy (3.50 ± 1.59), at the end of RT (3.05 ± 1.56) and one month after RT (2.52 ± 1.46). There was also a significant difference (P < 0.001) of the mean of SUVmax of neck node site. However, there was a significant difference of the SUVmax between histological WHO type IIb and type IIa in the primary site (P = 0.046) [(67 ± 19)% reduction at dose 50 Gy for type IIb vs. (55 ± 24)% for type IIa] but not in the lymph nodes.</p><p><b>CONCLUSIONS</b>Early PET scan during or right after RT instead of conventional 3 months interval after RT is indicated to evaluate the tumor response and to develop individualized adaptive radiotherapy in NPC. Our next study will attempt to demonstrate the results based on long-term follow-up data.</p>
