METABOLIC IMAGING BY PET OF CHEMO & THERMOCHEMO RESPONSE

化疗 PET 代谢成像

• 批准号: 3193816
• 负责人: JOAN M. BULL
• 金额: $ 26.29万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
• 依托单位国家: 美国
• 财政年份: 1992
• 资助国家: 美国
• 起止时间: 1992-08-01 至 1995-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3193816
• 关键词: colon neoplasms; computed axial tomography; deoxyglucose; early diagnosis; glucose metabolism; human subject; human therapy evaluation; liver neoplasms; magnetic resonance imaging; metastasis; neoplasm /cancer chemotherapy; neoplasm /cancer diagnosis; neoplasm /cancer thermotherapy; noninvasive diagnosis; positron emission tomography; ultrasonography

A striking feature of neoplastic cells is their exceptionally high rate of glycolysis compared to normal tissue. Our aim is to exploit this biological difference as a sensitive diagnostic tool and a specific indicator of response to tumor-directed treatment. Glucose uptake and phosphorylation will be estimated using [18F]-2-fluoro-2-deoxyglucose (18FDG) and positron emission tomography (PET). Any detected alteration in tumor metabolism will be compared to conventional measurements of tumor response. Specifically, our proposed studies are designed to demonstrate that PET can measure early changes in glucose metabolism following chemotherapy and particularly, thermochemo-therapy, because such treatment should cause rapid alterations in tumor metabolism. It is our assumption that early detection of tumor response to therapy will favorably affect the ultimate therapeutic outcome by allowing prompt modification of treatment. Preliminary studies are presented which have indicated that (1) metabolic imaging with PET detects glucose metabolism in metastatic tumor; (2) it is likely to be a more sensitive method that conventional techniques; (3) it can show metabolic changes in response to therapy, and (4) it shows metabolic changes in tumor 10 days after heat alone. We now propose to confirm these initial observations. Sixty patients with liver metastases from colon cancer will be treated with either a chemotherapy regimen (40 patients) or with whole body (WBH) hyperthermia combined with the same chemotherapy regimen (thermo-chemotherapy) (20 patients). The glucose metabolism of the metastases will be measured by PET imaging with 18FDG. Uptake and metabolic rate of 18FDG will be estimated prior to treatment in all patients, as well as 28 days after treatment. While pre-clinical data suggest that thermo-chemotherapy will cause a more rapid and a greater tumor response than will chemotherapy alone, these studies are specifically designed to determine if, at one month, a response to either a regimen of chemotherapy or to thermo-chemotherapy can be determined, and to give an indication of the relative sensitivity of individual liver metastases to chemotherapy versus the combined therapy. It is expected that metabolic imaging of tumor metastases with 18FDG and PET will be more specific and more sensitive indicator of tumor status than any other technique hitherto available. This information will broadly impact the entire field of clinical cancer therapy.

肿瘤细胞的一个显著特征是它们异常高的增殖率。 糖酵解与正常组织相比。 我们的目标是利用这个 生物学差异作为敏感的诊断工具和特异性 对肿瘤定向治疗反应指标。 葡萄糖摄取和 使用[18F]-2-氟-2-脱氧葡萄糖估计磷酸化 （18FDG）和正电子发射断层扫描（PET）。 任何检测到的 肿瘤代谢将与肿瘤的常规测量进行比较， 反应 具体来说，我们提出的研究旨在证明 PET可以测量葡萄糖代谢的早期变化 化疗，特别是热化疗，因为这种治疗 会导致肿瘤代谢的迅速改变 我们假设 早期检测肿瘤对治疗的反应将有利地影响 最终的治疗结果，允许及时修改治疗。 初步研究表明，（1）代谢 PET成像检测转移性肿瘤中的葡萄糖代谢;（2）它是 可能是一种比传统技术更敏感的方法;（3）它 可以显示治疗后的代谢变化，以及（4）它显示 单独加热后10天肿瘤的代谢变化。 我们现建议 证实了这些初步观察结果。 60例肝转移患者 结肠癌患者将接受化疗方案（40 患者）或与全身（WBH）热疗结合 化疗方案（热化疗）（20例患者）。 葡萄糖 通过18FDG的PET成像测量转移的代谢。 在治疗前估计18FDG的摄取和代谢率， 所有患者，以及治疗后28天。 虽然临床前数据 表明热化疗将导致更快和更大的 肿瘤反应将比单独化疗，这些研究是特别 旨在确定在一个月时， 化疗或热化疗可以确定，并给予 个体肝转移瘤对以下指标的相对敏感性： 化疗与联合治疗的比较 预计代谢 用18FDG和PET进行肿瘤转移的成像将更具特异性， 比迄今为止的任何其他技术都更灵敏的肿瘤状态指标 available. 这些信息将广泛影响整个领域， 临床癌症治疗