Exploratory prospective trial of hypoxia-specific PET imaging during radiochemotherapy in patients with locally advanced head-and-neck cancer

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Daniel Zips - , University Hospital Carl Gustav Carus Dresden (Author)
  • Klaus Zöphel - , University Hospital Carl Gustav Carus Dresden, Department of Nuclear Medicine (Author)
  • Nasreddin Abolmaali - , University Hospital Carl Gustav Carus Dresden, Institute and Polyclinic of Diagnostic and Interventional Radiology (Author)
  • Rosalind Perrin - , OncoRay - National Centre for Radiation Research in Oncology (Author)
  • Andrij Abramyuk - , University Hospital Carl Gustav Carus Dresden, Institute and Polyclinic of Diagnostic and Interventional Neuroradiology (Author)
  • Robert Haase - , OncoRay - National Center for Radiation Research in Oncology (Author)
  • Steffen Appold - , Department of Radiotherapy and Radiooncology, University Hospital Carl Gustav Carus Dresden (Author)
  • Jörg Steinbach - , Helmholtz-Zentrum Dresden-Rossendorf (Author)
  • Jörg Kotzerke - , Department of Nuclear Medicine, University Hospital Carl Gustav Carus Dresden (Author)
  • Michael Baumann - , Department of Radiotherapy and Radiooncology, University Hospital Carl Gustav Carus Dresden, Helmholtz-Zentrum Dresden-Rossendorf (Author)

Abstract

Purpose: To explore in a prospective trial the prognostic value of hypoxia imaging before and during radiochemotherapy in patients with locally advanced head and neck cancer. Patients and methods: Twenty-five patients with stage III/IV head and neck cancer were investigated with [18F]- fluoromisonidazole (FMISO) PET/CT at four time points during radiochemotherapy (baseline, 8-10 Gy, 18-20 Gy,50-60 Gy). FMISO PET/CT image parameters were extracted including maximum-tumour-to-background (TBRmax) and thresholded volume at different TBR ratios. CT volume and baseline FDG-PET/CT image parameters were also included. Parameters at all time points were investigated for their prognostic value with the local-progression-free-survival endpoint (LPFS). Significance was evaluated with multivariate Cox (including clinical parameters) and Log-rank tests. Results: FMISO-image parameters were found to have a strong association with the LPFS endpoint, and were strongest at the week 1 and 2 time points (p = 0.023-0.048 and 0.042-0.061 respectively on multivariate Cox). Parameters measured at baseline were only significant on univariate analysis. None of the clinical parameters, and also FDG- or CT-delineated volumes, were significantly associated with LPFS. Conclusion: This prospective, exploratory study demonstrated that FMISO-PET/CT imaging during the initial phase of treatment carries strong prognostic value. FMISO-PET/CT imaging at 1 or 2 weeks during treatment could be promising way to select patients that would benefit from hypoxia modification or dose-escalated treatment. A validation study is on-going.

Details

Original languageEnglish
Pages (from-to)21-28
Number of pages8
JournalRadiotherapy and oncology
Volume105
Issue number1
Publication statusPublished - Oct 2012
Peer-reviewedYes

External IDs

PubMed 23022173

Keywords

Sustainable Development Goals

Keywords

  • [F]-misonidazole-PET, Head-and-neck cancer, Radiotherapy