Lowe V J, Dunphy F R, Varvares M, Kim H, Wittry M, Dunphy C H, Dunleavy T, McDonough E, Minster J, Fletcher J W, Boyd J H
Department of Nuclear Medicine, St. Louis University Health Sciences Center, PET Imaging Facility, Missouri 63110-0250, USA.
Head Neck. 1997 Dec;19(8):666-74. doi: 10.1002/(sici)1097-0347(199712)19:8<666::aid-hed4>3.0.co;2-3.
[F-18]Fluorodeoxyglucose (FDG)-positron emission tomography (PET) can measure the metabolic activity of tissues; FDG-PET may be able to predict response to chemotherapy by identifying changes in tumor metabolism. Measurement of response to treatment may help improve survival in the management of advanced head and neck cancer. We evaluated this particular use of FDG-PET in patients participating in a neoadjuvant organ-preservation protocol using taxol and carboplatin and compared pathologic response after chemotherapy with changes in tumor metabolism measured by FDG-PET.
Serial FDG-PET studies (n = 56) were performed in patients (n = 28) with stage III/IV head and neck cancer participating in a neoadjuvant organ-preservation protocol. The FDG-PET studies were performed before and after chemotherapy. All patients had tissue biopsies before and after chemotherapy. Patients were classified as pathologic complete response (PCR) or residual disease (RD) based on tissue biopsies. Visual analysis of PET scans was performed to identify patients with complete response by PET, and these findings were compared with pathology results. Metabolic changes were also evaluated using standardized uptake ratios (SUR) of FDG.
The sensitivity and specificity of PET for residual cancer after therapy was 90% (19/21) and 83% (5/6), respectively. Two patients had initially negative biopsies and positive PET studies for persistent disease. Pathology review and rebiospy led to confirmation of the PET results in these cases, giving a sensitivity of 90% for initial tissue biopsy.
In this preliminary analysis, FDG-PET was accurate in classifying response to chemotherapy in most patients. Fluorodeoxyglucose-PET may identify residual viable tumor when it is otherwise undetectable.
[F-18]氟脱氧葡萄糖（FDG）-正电子发射断层扫描（PET）可测量组织的代谢活性；FDG-PET或许能够通过识别肿瘤代谢变化来预测化疗反应。评估治疗反应可能有助于改善晚期头颈癌治疗中的生存率。我们在参与一项使用紫杉醇和卡铂的新辅助器官保留方案的患者中评估了FDG-PET的这一特殊用途，并将化疗后的病理反应与通过FDG-PET测量的肿瘤代谢变化进行了比较。
对参与新辅助器官保留方案的28例III/IV期头颈癌患者进行了系列FDG-PET研究（n = 56）。在化疗前后进行了FDG-PET研究。所有患者在化疗前后均进行了组织活检。根据组织活检将患者分为病理完全缓解（PCR）或残留疾病（RD）。对PET扫描进行视觉分析以识别PET显示完全缓解的患者，并将这些结果与病理结果进行比较。还使用FDG的标准化摄取值（SUR）评估代谢变化。
PET对治疗后残留癌的敏感性和特异性分别为90%（19/21）和83%（5/6）。两名患者最初活检结果为阴性，但PET研究显示持续性疾病为阳性。病理复查和再次活检证实了这些病例中的PET结果，初始组织活检的敏感性为90%。
在这项初步分析中，FDG-PET在大多数患者中准确地分类了化疗反应。当其他方法无法检测到时，氟脱氧葡萄糖-PET可能识别出残留的存活肿瘤。
