Serial [18F]-fluoromisonidazole PET during radiochemotherapy for locally advanced head and neck cancer and its correlation with outcome.
Publisher DOI
PubMed ID
26432067
Abstract
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.
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.
Date Issued
2015-10
Publication Type
Article
Subject(s)
Subjects
18F-MISO
•
Head and neck cancer
•
Hypoxia
•
PET
•
Radiochemotherapy
Language(s)
en
Author(s)
Wiedenmann, Nicole E | |
Bucher, Sabine | |
Mix, Michael | |
Vach, Werner | |
Bittner, Martin-Immanuel | |
Nestle, Ursula | |
Pfeiffer, Jens | |
Weber, Wolfgang A | |
Grosu, Anca L |
Additional Credits
Journal
Radiotherapy and oncology
Publisher
Elsevier
ISSN
0167-8140
Access(Rights)
restricted