Prospective trial incorporating pre-/mid-treatment [18F]-misonidazole positron emission tomography for head-and-neck cancer patients undergoing concurrent chemoradiotherapy.
Prospective trial incorporating pre-/mid-treatment [18F]-misonidazole positron emission tomography for head-and-neck cancer patients undergoing concurrent chemoradiotherapy.
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DOI：
10.1016/j.ijrobp.2008.10.049
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发表时间：
2009-09-01
影响因子：
7
通讯作者：
Humm, John
中科院分区：
文献类型：
--
作者：
Lee, Nancy;Nehmeh, Sadek;Schoeder, Heiko;Fury, Matthew;Chan, Kelvin;Ling, C. Clifton;Humm, John
报告一系列接受铂类化疗和调强放疗的局部晚期头颈癌患者的前瞻性研究结果，并讨论其治疗前/治疗中[18 F]-米索咪唑（18 F-FMISO）正电子发射断层扫描（PET）的结果。共有28名患者同意参加本研究。在这28例患者中，20例（90%患有口咽原发性癌症）能够接受方案的要求。每例患者均接受了4次PET扫描：1次治疗前氟脱氧葡萄糖PET/计算机断层扫描，2次治疗前18F-FMISO PET/计算机断层扫描，第3次18F-FMISO PET（治疗中期）扫描在放化疗开始后4周进行。在示踪剂施用后2-3小时获得18F-FMISO PET扫描。患者接受2-3个周期的铂类化疗，同时接受确定性调强放疗。在90%的患者中，18F-FMISO在原发性和/或淋巴结疾病中的分布不均匀。两名患者在第三次治疗中期18F-FMISO PET扫描中出现持续可检测到的缺氧。1例患者出现局部/远端失效，但在治疗中期18F-FMISO PET扫描中未检测到残留缺氧。尽管20例患者中有18例患者的治疗前18F-FMISO PET/计算机断层扫描显示可检测到缺氧，但在该系列接受铂类化疗和调强放疗的头颈部癌症患者中观察到了极好的局部控制。在这项前瞻性研究中，治疗中期PET扫描阳性18F-FMISO结果所定义的缺氧的存在或不存在均与患者结局无关。这项研究的结果证实了以前报道的类似结果。
To report the results from a prospective study of a series of locoregionally advanced head-and-neck cancer patients treated with platinum-based chemotherapy and intensity-modulated radiotherapy and to discuss the findings of their pre-/mid-treatment [18F]-misonidazole (18F-FMISO) positron emission tomography (PET) scans. A total of 28 patients agreed to participate in this study. Of these 28 patients, 20 (90% with an oropharyngeal primary cancer) were able to undergo the requirements of the protocol. Each patient underwent four PET scans: one pretreatment fluorodeoxyglucose PET/computed tomography scan, two pretreatment 18F-FMISO PET/computed tomography scans, and a third 18F-FMISO PET (mid-treatment) scan performed 4 weeks after the start of chemoradiotherapy. The 18F-FMISO PET scans were acquired 2–3 h after tracer administration. Patients were treated with 2–3 cycles of platinum-based chemotherapy concurrent with definitive intensity-modulated radiotherapy. A heterogeneous distribution of 18F-FMISO was noted in the primary and/or nodal disease in 90% of the patients. Two patients had persistent detectable hypoxia on their third mid-treatment 18F-FMISO PET scan. One patient experienced regional/distant failure but had no detectable residual hypoxia on the mid-treatment 18F-FMISO PET scan. Excellent locoregional control was observed in this series of head-and-neck cancer patients treated with concurrent platinum-based chemotherapy and intensity-modulated radiotherapy despite evidence of detectable hypoxia on the pretreatment 18F-FMISO PET/computed tomography scans of 18 of 20 patients. In this prospective study, neither the presence nor the absence of hypoxia, as defined by positive 18F-FMISO findings on the mid-treatment PET scan, correlated with patient outcome. The results of this study have confirmed similar results reported previously.
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