PREDICTING HUMAN TUMOR RESPONSE BY 31P MRS

描述：来自UCSF的此应用程序是八个协调的应用程序之一。 支持多中心临床试验的申请， 探讨~（31）P磁共振波谱（31-PMRS）对肿瘤的预测和评价价值 对治疗的反应。 尽管，八个参与者中的每一个 机构将进行自己的独立研究，同样的数据， 采集和分析程序将用于所有机构， 获得可比较的、可重复的结果。 每个机构 将提交他们对患者的连续研究结果， 肉瘤、乳腺肿瘤、非霍奇金斯淋巴瘤或头颈部肿瘤 癌症进行中心统计分析。 假设是 试验表明，预处理pH和T2可以预测处理效果 有效性和31-P代谢物早期变化表明 对治疗的反应。 这些假设是基于初步数据 从大量的研究中。 加州大学旧金山分校正在考虑的病人 患有头颈部鳞状细胞癌 20例患者/ 今年将从已经参加的个人中招募 在多中心试验RTOG 88-17、RTOG 90-03或RTOG 91-11中。 的 被比较的治疗是不同类型的组合， 分次放疗，在某些情况下，额外的化疗。 MRI和质子去耦合3D 31-P定位MRS检查，将 用于表征治疗前颈部的转移性淋巴结， 放射治疗开始后第2、8和20天以及结束时 心理治疗 这些将决定31-P数据是否能够 预测放射治疗的有效性，检测缺乏 在早期阶段的反应或指导决定是否辐照后节点 需要解剖。 钆摄取的MRI及动态研究 也将在治疗前、放射治疗结束时进行， 在随后的3个月随访中。 这些研究将提供试点 数据调查的假设，钆的变化率 摄取可以帮助区分活动性或复发性肿瘤 坏死 如果是这种情况，MRI随访可能证明有效， 检测早期复发。 这一结果和整体 分析31-P MRS数据将提供有价值的信息， 对各种各样的病人的管理产生重大影响 不同的癌症。

DESCRIPTION: This application from the UCSF, is one of eight coordinated applications to support a multi-center clinical trial which will investigate the efficacy of 31-P MRS in predicting and evaluating tumor response to therapy. Although, each of the eight participating institutions will perform their own independent research, the same data acquisition and analysis procedures will be used in all institutions so that comparable, reproducible results are obtained. Each institution will submit the results of their sequential studies on patients with either sarcomas, breast tumors, non- Hodgkins lymphomas or head and neck carcinomas for central statistical analyses. The hypotheses being tested are that pre-treatment pH and T2 can predict of treatment effectiveness and that early changes in 31-P metabolites indicate response to therapy. These hypotheses are based upon preliminary data from numerous research studies. The patients being considered at UCSF have squamous cell carcinoma of the head and neck. Twenty patients per year will be recruited from individuals who are already participating in the multi- center trials RTOG 88-17, RTOG 90-03 or RTOG 91-11. The treatments being compared are combinations of different types of fractionated radiotherapy with, in some cases, additional chemotherapy. MRI and proton decoupled 3 D 31-P localized MRS examinations, will be used to characterize metastatic lymph nodes of the neck pre-treatment, at 2, 8 and 20 days after the start of radiation therapy and at the end of therapy. These will determine whether the 31-P data are able to predict the effectiveness of the radiation therapy, detect lack of response at an early stage or guide in deciding if post- irradiation node dissection is required. MRI and dynamic studies of Gadolinium uptake will also be performed pre-treatment, at the end of radiation therapy and at subsequent 3 monthly follow-ups. These studies will provide pilot data to investigate the hypothesis that changes in rate of Gadolinium uptake may assist in distinguishing active or recurrent tumor from necrosis. If this is the case, MRI follow-up may prove effective in detecting early recurrence. The results of this and the overall analysis of 31-P MRS data will provide valuable information which could have a major impact on the management of patients with a wide variety of different cancers.