Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Lancet Oncol. 2010 Jul;11(7):661-9. doi: 10.1016/S1470-2045(09)70353-5. Epub 2010 Mar 10.
Preferred treatment strategies for advanced-stage squamous cell carcinoma of the head and neck have shifted from surgery to organ-preservation approaches such as radiotherapy, which can be combined with chemotherapy or giving of biologically modifying molecules. Preclinical and clinical researchers aim to customise these treatments on the basis of biological tumour characteristics, including tumour cell proliferation, hypoxia, and apoptosis--important resistance mechanisms for cytotoxic antitumour therapy. Monitoring of these biologically relevant variables before and early during treatment could improve patient selection for specific treatment strategies and guide adaptation of treatment at an early stage. PET provides a non-invasive molecular imaging method with the potential ability to undertake repetitive non-invasive quantification of relevant tumour characteristics. We discuss the role of PET scanning and available radiopharmaceutical tracers for treatment selection, early response monitoring, and treatment adaptation in head and neck cancer.
晚期头颈部鳞状细胞癌的首选治疗策略已从手术转向器官保留方法，如放疗，放疗可与化疗或生物修饰分子联合使用。临床前和临床研究人员旨在根据生物肿瘤特征（包括肿瘤细胞增殖、缺氧和细胞凋亡）来定制这些治疗方法，这些特征是细胞毒性抗肿瘤治疗的重要耐药机制。在治疗前和早期监测这些与生物学相关的变量可以改善对特定治疗策略的患者选择，并指导早期治疗的调整。PET 提供了一种非侵入性的分子成像方法，具有重复进行相关肿瘤特征的非侵入性定量的潜力。我们讨论了 PET 扫描在头颈部癌症中的治疗选择、早期反应监测和治疗调整中的作用以及可用的放射性药物示踪剂。
