局部晚期头颈癌放化疗期间的系列[18F]氟米索硝唑PET及其与预后的相关性
Serial [18F]-fluoromisonidazole PET during radiochemotherapy for locally advanced head and neck cancer and its correlation with outcome.
作者信息
Wiedenmann Nicole E, Bucher Sabine, Hentschel Michael, Mix Michael, Vach Werner, Bittner Martin-Immanuel, Nestle Ursula, Pfeiffer Jens, Weber Wolfgang A, Grosu Anca L
机构信息
Department of Radiation Oncology, German Cancer Consortium/Partner site Freiburg, University Medical Center Freiburg, Germany.
Department of Radiation Oncology, German Cancer Consortium/Partner site Freiburg, University Medical Center Freiburg, Germany; Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Switzerland.
出版信息
Radiother Oncol. 2015 Oct;117(1):113-7. doi: 10.1016/j.radonc.2015.09.015. Epub 2015 Sep 29.
PURPOSE
The aim was to assess changes of tumour hypoxia during primary radiochemotherapy (RCT) for head and neck cancer (HNC) and to evaluate their relationship with treatment outcome.
MATERIAL AND METHODS
Hypoxia was assessed by FMISO-PET in weeks 0, 2 and 5 of RCT. The tumour volume (TV) was determined using FDG-PET/MRI/CT co-registered images. The level of hypoxia was quantified on FMISO-PET as TBRmax (SUVmaxTV/SUVmean background). The hypoxic subvolume (HSV) was defined as TV that showed FMISO uptake ⩾1.4 times blood pool activity.
RESULTS
Sixteen consecutive patients (T3-4, N+, M0) were included (mean follow-up 31, median 44months). Mean TBRmax decreased significantly (p<0.05) from 1.94 to 1.57 (week 2) and 1.27 (week 5). Mean HSV in week 2 and week 5 (HSV2=5.8ml, HSV3=0.3ml) were significantly (p<0.05) smaller than at baseline (HSV1=15.8ml). Kaplan-Meier plots of local recurrence free survival stratified at the median TBRmax showed superior local control for less hypoxic tumours, the difference being significant at baseline and after 2weeks (p=0.031, p=0.016).
CONCLUSIONS
FMISO-PET documented that in most HNC reoxygenation starts early during RCT and is correlated with better outcome.
目的
评估头颈部癌（HNC）患者在接受原发性放化疗（RCT）期间肿瘤缺氧情况的变化，并评估其与治疗结果的关系。
材料与方法
在RCT的第0、2和5周通过氟代吗哚乙酸（FMISO）-正电子发射断层扫描（PET）评估缺氧情况。使用氟代脱氧葡萄糖（FDG）-PET/磁共振成像（MRI）/计算机断层扫描（CT）融合图像确定肿瘤体积（TV）。在FMISO-PET上，缺氧水平定量为最大肿瘤-本底放射性比（TBRmax，SUVmax肿瘤/SUV平均本底）。缺氧亚体积（HSV）定义为显示FMISO摄取≥血池活性1.4倍的TV。
结果
纳入16例连续患者（T3-4，N+，M0）（平均随访31个月，中位数44个月）。平均TBRmax从1.94显著下降（p<0.05）至1.57（第2周）和1.27（第5周）。第2周和第5周的平均HSV（HSV2 = 5.8ml，HSV3 = 0.3ml）显著（p<0.05）小于基线时（HSV1 = 15.8ml）。以TBRmax中位数分层的无局部复发生存的Kaplan-Meier曲线显示，缺氧程度较低的肿瘤局部控制效果更好，在基线和2周后差异显著（p = 0.031，p = 0.016）。
结论
FMISO-PET表明，在大多数HNC患者中，再氧合在RCT早期开始，且与更好的治疗结果相关。
Zotero 插件