From the *Department of Otolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen; †Graduate School of Medical Sciences (Groningen University Institute for Drug Exploration), ‡Department of Radiation Oncology, §Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, the Netherlands; and ∥Department of Nuclear Medicine, Tygerberg Hospital, Stellenbosch University, Stellenbosch, South Africa.
Clin Nucl Med. 2014 Jan;39(1):44-8. doi: 10.1097/RLU.0000000000000286.
Tumor hypoxia is known to be associated with poor clinical outcome; therefore, patients with hypoxic tumors might benefit from more intensive treatment approaches. This is particularly true for patients with head and neck cancer. Pretreatment assessment of hypoxia in tumors would be desirable, not only to predict prognosis but also to select patients for more aggressive treatment.As an alternative to the invasive polarographic needle electrode method, there is the possibility of using PET with radiopharmaceuticals visualizing hypoxia. Most hypoxia imaging studies on head and cancer have been performed using F-labeled fluoromisonidazole (F-FMISO). A chemically related molecule, F-fluoroazomycin-arabinoside (F-FAZA), seems to have superior kinetic properties and may therefore be the radiopharmaceutical of choice.This minireview summarizes the published literature on animal and human F-FAZA PET studies. Furthermore, future perspectives on how individualized treatment could be applied in patients with hypoxic head and neck tumors are discussed, for instance, the use of hypoxia sensitizers or special intensity-modulated radiation therapy techniques achieving tumor subvolume dose escalation.
肿瘤缺氧与不良的临床预后相关，因此，缺氧肿瘤患者可能会受益于更强化的治疗方法。这在头颈部癌症患者中尤其如此。在肿瘤中进行缺氧的预处理评估不仅可以预测预后，还可以选择更积极的治疗方法。作为侵入性的极谱针电极方法的替代方法，有可能使用正电子发射断层扫描 (PET) 放射性药物来可视化缺氧。大多数关于头颈部癌症的缺氧成像研究都使用 F 标记的氟米索硝唑 (F-FMISO) 进行。一种化学上相关的分子，F-氟代吖啶阿拉伯糖苷 (F-FAZA)，似乎具有更好的动力学特性，因此可能是首选的放射性药物。这篇迷你综述总结了关于 F-FAZA PET 研究的动物和人类文献。此外，还讨论了如何在缺氧的头颈部肿瘤患者中应用个体化治疗的未来前景，例如使用缺氧增敏剂或特殊强度调制放射治疗技术来实现肿瘤亚体积剂量递增。
