FDG-PET to evaluate intraarterial chemoradiotherapy as organ preservation protocol in oral squamous cell carcinoma

FDG-PET 评估动脉内放化疗作为口腔鳞状细胞癌的器官保存方案

• 批准号: 15592103
• 负责人: KITAGAWA Yoshimasa
• 金额: $ 2.18万
• 依托单位: Hokkaido University (2004)福井医科大学 (2003)
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2003
• 资助国家: 日本
• 起止时间: 2003 至 2004
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-15592103/
• 关键词: Oral Cancer; FDG-PET; FLT; intraarterial chemotherapy; organ preservation; prediction of prognosis; proliferative potential; SUV; 治療効果判定; 予後判定; 縮小手術

Recently, neoadiuvant chemoradiotherapy as an organ-preserving protocol has shown good clinical response in patients with oral cancer. Accurate evaluation of therapeutic effect is essential to determine further operation after the chemoradiotherapy in consideration of the patients prognosis and quality of life. The aim of this study was to evaluate the possible usefulness of positron emission tomography with 18F labeled fluorodeoxyglucose (FDG-PET) for predicting response to intraarterial chemoradiotherapy (THP-ADM+5-FU+carboplatin), and prognosis in oral carcinomas.Materials and Methods : Thirty-five patients with oral squamous cell carcinoma (SCC) were included in the study. All patients completed the treatment regimen, and each patient underwent 2 FDG-PET studies, one prior to and one at 4 weeks after the chemoradiotherapy. The pre-and post-treatment PET images were compared with clinical and histopathological evaluations of the treatment effect. For the quantitative evaluation of r … More egional radioactivity, standardized uptake values (SUVs) were used.Results : The chemoradiotherapy demonstrated good clinical response (Overall clinical response rate 100% ; CR rate 71%) and histological response (p-CR rate 83%). All neoplastic lesions showed high SUVs (mean, 10.00mg/ml) prior to the treatment, which values significantly decreased after the therapy (3.74mg/ml, p<0.01). Change in FDG uptake paralleled the treatment effect. Lesions with higher pre-SUVs (_7 mg/mL) showed residual viable tumor cells after the treatment in 6 out of 25 patients, and 3-year survival rate of 79%. whereas those with lower SUVs (<7mg/mL, 10 patients) were successfully treated, and showed significantly higher 3-year survival (100%). Six out of 13 tumors with post-SUVs _4 mg/ml had viable tumor cells, whereas all (22/22) tumors with post-SUVs <4 mg/mL showed no viable cells. Based on PET results, 10 patients avoided operation altogether, and 19 patients underwent a reduced form of surgery. Each patient showed no local recurrence within 5-year follow-up.Conclusions : Concomitant chemoradiotherapy is effective for head and neck carcinoma. Pretreatment FDG-PET is useful in predicting the response to treatment and prognosis. Posttreatment FDG-PET can evaluate residual viable cells. Organ preservation may be feasible based on PET evaluation. Hence FDG-PET is a valuable tool in the treatment of oral cancer. Less

近年来，新辅助放化疗作为一种器官保护方案在口腔癌患者中显示出良好的临床反应。准确的疗效评价是决定放化疗后是否手术的关键，应综合考虑患者的预后和生活质量。本研究的目的是评估可能有用的正电子发射断层扫描与18F标记的氟脱氧葡萄糖（FDG-PET）预测动脉内放化疗（THP-ADM+5-FU+卡铂），在口腔癌预后。材料和方法：35例口腔鳞状细胞癌（SCC）被纳入本研究。所有患者均完成治疗方案，每例患者接受2次FDG-PET检查，一次在放化疗前，一次在放化疗后4周。将治疗前和治疗后的PET图像与治疗效果的临床和组织病理学评价进行比较。对于R的定量评价， ...更多信息 结果：放化综合治疗组临床有效率为100%，完全缓解率为71%，组织学缓解率为83%。所有肿瘤性病变治疗前均显示高SUV（平均10.00mg/ml），治疗后SUV值显著降低（3.74mg/ml，p<0.01）。FDG摄取的变化与治疗效果有关。具有较高pre-SUV（_7mg/mL）的病变在25名患者中的6名中在治疗后显示出残余的存活肿瘤细胞，并且3年存活率为79%。而SUV值较低的患者（<7 mg/mL，10例患者）成功治疗，3年生存率显著较高（100%）。SUV后浓度为_4mg/ml的13个肿瘤中有6个具有活的肿瘤细胞，而SUV后浓度<4 mg/mL的所有（22/22）肿瘤均显示无活细胞。根据PET结果，10例患者完全避免了手术，19例患者接受了简化形式的手术。结论：同步放化疗是治疗头颈部恶性肿瘤的有效方法。治疗前FDG-PET可用于预测治疗反应和预后。治疗后FDG-PET可以评估残留的活细胞。基于PET评价，器官保存可能是可行的。因此，FDG-PET在口腔癌的治疗中是一个有价值的工具。少

项目成果

Kitagawa Y, Sano K, Nishizawa S, et al.: "FDG-PET for prediction of tumour aggressiveness and response to intra-arterial chemotherapy and radiotherapy in head and neck cancer"Eur J Nucl Med Mol Imaging. 30. 63-71 (2003)

Kitakawa Y、Sano K、Nishizawa S 等人：“FDG-PET 用于预测头颈癌肿瘤侵袭性以及对动脉内化疗和放疗的反应”Eur J Nucl Med Mol Imaging。

Prospective comparison of 18F-FDG PET with conventional imaging modalities (MRI, CT, and 67Ga scintigraphy) in assessment of combined intraarterial chemotherapy and radiotherapy for head and neck carcinoma.

• 发表时间: 2003-02
• 期刊: Journal of nuclear medicine : official publication, Society of Nuclear Medicine
• 作者: Y. Kitagawa;S. Nishizawa;K. Sano;T. Ogasawara;Mikiko Nakamura;N. Sadato;Masanori Yoshida;Y. Yonekura-Y.-Yon

FDG-PET to evaluate response to intraarterial chemoradiotherapy in oral squamous cell carcinoma.

FDG-PET 评估口腔鳞状细胞癌动脉内放化疗的反应。

• 发表时间: 2005
• 期刊: Head and Neck Cancer 31(in press)
• 作者: Kitagawa Y;Sano K;et al.
• 通讯作者: et al.

Diagnostic significance of FDG-PET and argyrophilic nucleolar organizer regions (AgNORs) in oral squamous cell carcinoma

• DOI: 10.1016/s1368-8375(03)00151-9
• 发表时间: 2004-02-01
• 期刊: ORAL ONCOLOGY
• 影响因子: 4.8
• 作者: Nakamura, M;Sano, K;Yonekura, Y
• 通讯作者: Yonekura, Y

口腔外科領域:クリニカルPET最前線

口腔外科领域：临床PET一线

• 发表时间: 2004
• 作者: 北川善政;米倉義晴;佐野和生
• 通讯作者: 佐野和生