Evaluation of chemotherapy response in patients with advanced head and neck cancer using [F-18]fluorodeoxyglucose positron emission tomography
Evaluation of chemotherapy response in patients with advanced head and neck cancer using [F-18]fluorodeoxyglucose positron emission tomography
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DOI：
10.1002/(sici)1097-0347(199712)19:8
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发表时间：
1997-12-01
影响因子：
2.9
通讯作者：
Boyd, JH
中科院分区：
文献类型：
--
作者：
Lowe, VJ;Dunphy, FR;Boyd, JH
背景资料。[F-18]氟脱氧葡萄糖(FDG)-正电子发射断层扫描(PET)可以测量组织的代谢活动；FDG-PET可能能够通过识别肿瘤代谢的变化来预测对化疗的反应。对治疗反应的测量可能有助于提高晚期头颈癌治疗的存活率。我们在使用紫杉醇和卡铂的新辅助器官保存方案的患者中评估了FDG-PET的这种特殊应用，并将化疗后的病理反应与FDG-PET测量的肿瘤代谢变化进行了比较。对参与新辅助器官保存方案的28例III/IV期头颈癌患者进行了一系列FDG-PET研究(n=56)。化疗前后分别进行FDG-PET检查。所有患者在化疗前后都进行了组织活检。根据组织活检将患者分为病理完全应答(PCR)或残留病(RD)。对PET扫描进行目测分析，以确定PET完全反应的患者，并将这些发现与病理结果进行比较。用FDG的标准摄取比(SUR)评价代谢变化。PET对治疗后残留癌的敏感性为90%(19/21)，特异性为83%(5/6)。两名患者最初活检为阴性，PET检查为持续性疾病阳性。病理复查和复检证实了这些病例的正电子发射计算机断层扫描结果，对初始组织活检的敏感性为90%。在这一初步分析中，FDG-PET对大多数患者的化疗反应进行分类是准确的。氟脱氧葡萄糖-正电子发射计算机断层扫描可以在其他情况下无法发现的情况下识别残留的存活肿瘤。(C)1997年John Wiley&Sons，Inc.
Background. [F-18]Fluorodeoxyglucose (FDG)-positron emission tomography (PET) can measure the metabolic activity of tissues; FDG-PET may be able to predict response to chemotherapy by identifying changes in tumor metabolism. Measurement of response to treatment may help improve survival in the management of advanced head and neck cancer. We evaluated this particular use of FDG-PET in patients participating in a neoadjuvant organ-preservation protocol using taxol and carboplatin and compared pathologic response after chemotherapy with changes in tumor metabolism measured by FDG-PET.Methods. Serial FDG-PET studies (n = 56) were performed in patients (n = 28) with stage III/IV head and neck cancer participating in a neoadjuvant organ-preservation protocol. The FDG-PET studies were performed before and after chemotherapy. All patients had tissue biopsies before and after chemotherapy. Patients were classified as pathologic complete response (PCR) or residual disease (RD) based on tissue biopsies. Visual analysis of PET scans was performed to identify patients with complete response by PET, and these findings were compared with pathology results. Metabolic changes were also evaluated using standardized uptake ratios (SUR) of FDG.Results. The sensitivity and specificity of PET for residual cancer after therapy was 90% (19/21) and 83% (5/6), respectively. Two patients had initially negative biopsies and positive PET studies for persistent disease. Pathology review and rebiospy led to confirmation of the PET results in these cases, giving a sensitivity of 90% for initial tissue biopsy.Conclusions. In this preliminary analysis, FDG-PET was accurate in classifying response to chemotherapy in most patients. Fluorodeoxyglucose-PET may identify residual viable tumor when it is otherwise undetectable. (C) 1997 John Wiley & Sons, Inc.