Exploratory prospective trial of hypoxia-specific PET imaging during radiochemotherapy in patients with locally advanced head-and-neck cancer
Exploratory prospective trial of hypoxia-specific PET imaging during radiochemotherapy in patients with locally advanced head-and-neck cancer
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DOI：
10.1016/j.radonc.2012.08.019
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发表时间：
2012-10-01
影响因子：
5.7
通讯作者：
Baumann, Michael
中科院分区：
文献类型：
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作者：
Zips, Daniel;Zoephel, Klaus;Baumann, Michael
目的：探讨在前瞻性试验中的预后价值的乏氧显像前和放疗期间的局部晚期头颈cancer.Patients和方法：25例III/IV期头颈癌患者进行了调查与[F-18]-氟咪唑（FMISO）PET/CT在4个时间点在放疗期间（基线，8-10戈伊，18-20戈伊，50-60戈伊）。提取FMISO PET/CT图像参数，包括不同TBR比下的最大肿瘤背景（TBRmax）和阈值体积。还包括CT体积和基线FDG-PET/CT图像参数。研究所有时间点的参数及其局部无进展生存期终点（LPFS）的预后价值。结果：FMISO图像参数与LPFS终点有很强的相关性，并且在第1周和第2周的时间点最强（多变量考克斯分别为p = 0.023-0.048和0.042-0.061）。基线时测量的参数仅在单变量分析中具有显著性。没有临床参数，也FDG或CT划定的体积，显着相关LPFS.Conclusion：这项前瞻性，探索性研究表明，FMISO-PET/CT成像在治疗的初始阶段进行强有力的预后价值。在治疗期间1或2周的FMISO-PET/CT成像可能是选择将从缺氧调整或剂量递增治疗中受益的患者的有希望的方法。验证研究正在进行中。(C)2012爱思唯尔爱尔兰有限公司保留所有权利。放射治疗与肿瘤学105（2012）21-28
Purpose: To explore in a prospective trial the prognostic value of hypoxia imaging before and during radiochemotherapy in patients with locally advanced head and neck cancer.Patients and methods: Twenty-five patients with stage III/IV head and neck cancer were investigated with [F-18]-fluoromisonidazole (FMISO) PET/CT at four time points during radiochemotherapy (baseline, 8-10 Gy, 18-20 Gy,50-60 Gy). FMISO PET/CT image parameters were extracted including maximum-tumour-to-background (TBRmax) and thresholded volume at different TBR ratios. CT volume and baseline FDG-PET/CT image parameters were also included. Parameters at all time points were investigated for their prognostic value with the local-progression-free-survival endpoint (LPFS). Significance was evaluated with multivariate Cox (including clinical parameters) and Log-rank tests.Results: FMISO-image parameters were found to have a strong association with the LPFS endpoint, and were strongest at the week 1 and 2 time points (p = 0.023-0.048 and 0.042-0.061 respectively on multivariate Cox). Parameters measured at baseline were only significant on univariate analysis. None of the clinical parameters, and also FDG- or CT-delineated volumes, were significantly associated with LPFS.Conclusion: This prospective, exploratory study demonstrated that FMISO-PET/CT imaging during the initial phase of treatment carries strong prognostic value. FMISO-PET/CT imaging at 1 or 2 weeks during treatment could be promising way to select patients that would benefit from hypoxia modification or dose-escalated treatment. A validation study is on-going. (C) 2012 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 105 (2012) 21-28