Assessing tumor hypoxia in cervical cancer by PET with 60Cu-labeled diacetyl-bis(N4-methylthiosemicarbazone)
Assessing tumor hypoxia in cervical cancer by PET with 60Cu-labeled diacetyl-bis(N4-methylthiosemicarbazone)
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DOI：
10.2967/jnumed.107.048520
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发表时间：
2008-02-01
影响因子：
9.3
通讯作者：
Welch, Michael J.
中科院分区：
文献类型：
--
作者：
Dehdashti, Farrokh;Grigsby, Perry W.;Welch, Michael J.
肿瘤缺氧提示预后不良。本研究旨在证实我们先前的初步结果，即通过Cu-60标记的二乙酰基-双（N-4-甲基缩氨基硫脲）（Cu-60-ATSM）PET证实的预处理肿瘤缺氧是宫颈癌患者预后不良的生物标志物。38例经活检证实的宫颈癌患者在开始放疗和化疗前接受了Cu-60-ATSM PET。60 Cu-ATSM摄取以肿瘤/肌肉活性比（T/M）半定量评价。使用对数秩检验来确定对预后具有强预测性的截止摄取值。所有患者在治疗前均接受了F-18-FDG临床PET。PET结果与临床随访相关。肿瘤60 Cu-ATSM摄取与无进展生存期和病因特异性生存期呈负相关（分别为P = 0.006和P = 0.04，如通过对数秩检验确定的）。我们发现，T/M阈值为3.5最能区分可能复发的患者和不太可能复发的患者;含氧量正常的肿瘤患者的3年无进展生存率（T/M为3.5）为28%（P = 0.01）。肿瘤F-18-FDG摄取与60 Cu-ATSM摄取无相关性，乏氧肿瘤患者与常氧肿瘤患者之间肿瘤18 F-FDG摄取无显著差异（P = 0.9）。治疗前Cu-60-ATSM PET可提供有关肿瘤氧合的临床相关信息，可预测宫颈癌患者的结局。
Tumor hypoxia indicates a poor prognosis. This study was undertaken to confirm our prior pilot results showing that pretreatment tumor hypoxia demonstrated by PET with Cu-60-labeled diacetyl-bis(N-4-methylthiosemicarbazone) (Cu-60-ATSM) is a biomarker of poor prognosis in patients with cervical cancer. Thirty-eight women with biopsy-proved cervical cancer underwent Cu-60-ATSM PET before the initiation of radiotherapy and chemotherapy. 60Cu-ATSM uptake was evaluated semiquantitatively as the tumor-to-muscle activity ratio (T/M). A log-rank test was used to determine the cutoff uptake value that was strongly predictive of prognosis. All patients also underwent clinical PET with F-18-FDG before the institution of therapy. The PET results were correlated with clinical follow-up. Tumor 60Cu-ATSM uptake was inversely related to progression-free survival and cause-specific survival (P = 0.006 and P = 0.04, respectively, as determined by the log-rank test). We found that a T/M threshold of 3.5 best discriminated patients likely to develop a recurrence from those unlikely to develop a recurrence; the 3-y progression-free survival of patients with normoxic tumors (as defined by T/M of 3.5) was 28% (P = 0.01). Tumor F-18-FDG uptake did not correlate with 60Cu-ATSM uptake, and there was no significant difference in tumor 18F-FDG uptake between patients with hypoxic tumors and those with normoxic tumors (P = 0.9). Pretherapy Cu-60-ATSM PET provides clinically relevant information about tumor oxygenation that is predictive of outcome in patients with cervical cancer.