The Royal Marsden NHS Trust, Surrey, United Kingdom.
Radiother Oncol. 2013 Jan;106(1):112-7. doi: 10.1016/j.radonc.2012.09.009. Epub 2012 Oct 22.
When induction chemotherapy (IC) is used prior to chemoradiotherapy (CRT) in head and neck cancer (HNC), functional imaging (FI) may inform adaptation of treatment plans with the aim of optimising outcomes. Understanding the impact of IC on FI parameters is, therefore, essential.
To prospectively evaluate the feasibility of acquiring serial FI ((18)F-FDG-PET, diffusion-weighted (DW) and dynamic contrast-enhanced (DCE) MRI) and its role in defining individualised treatment regimens following IC in HNC.
Ten patients with stage III and IV HNC underwent conventional (CT and MRI) and functional (DW, DCE-MRI and (18)F-FDG-PET/CT) imaging at baseline and following two cycles of IC prior to definitive CRT.
One patient withdrew due to claustrophobia. Seven out of nine patients had a complete metabolic response to IC on (18)F-FDG-PET imaging. DCE-MRI showed a significant fall in transfer constant (K(trans)) (0.209 vs 0.129 min(-1)P<0.01) and integrated area under gadolinium curve at 60s (IAUGC6O) (18.4 vs 11.9 mmol/min, P<0.01) and DW-MRI a rise in ADC (0.89 vs 1.06 × 10(-3) mm(2)/s, P<0.01) following IC.
Acquiring FI sequences is feasible in HNC. There are marked changes in FI parameters following IC which may guide adaptation of individualised treatment regimens.
在头颈部癌症（HNC）中，诱导化疗（IC）在放化疗（CRT）之前使用时，功能成像（FI）可以为治疗计划的调整提供信息，以优化治疗效果。因此，了解 IC 对 FI 参数的影响至关重要。
前瞻性评估在 HNC 中接受 IC 后连续获取 FI（（18）F-FDG-PET、弥散加权（DW）和动态对比增强（DCE）MRI）的可行性，及其在确定个体化治疗方案中的作用。
10 例 III 期和 IV 期 HNC 患者在接受常规（CT 和 MRI）和功能（DW、DCE-MRI 和（18）F-FDG-PET/CT）成像检查后，分别在基线和接受 2 个周期 IC 后进行了明确的 CRT。
1 例患者因幽闭恐惧症退出。7 例患者在（18）F-FDG-PET 成像上对 IC 有完全的代谢反应。DCE-MRI 显示转移常数（K(trans)）（0.209 比 0.129 min(-1)，P<0.01）和 60 秒时钆累积面积（IAUGC6O）（18.4 比 11.9 mmol/min，P<0.01）有显著下降，DW-MRI 显示 ADC 值（0.89 比 1.06×10(-3)mm(2)/s，P<0.01）升高。
在 HNC 中获取 FI 序列是可行的。IC 后 FI 参数有明显变化，可能指导个体化治疗方案的调整。
