Title | Prospective trial incorporating pre-/mid-treatment [18F]-misonidazole positron emission tomography for head-and-neck cancer patients undergoing concurrent chemoradiotherapy. |
Publication Type | Journal Article |
Year of Publication | 2009 |
Authors | Lee N, Nehmeh S, Schöder H, Fury M, Chan K, C Ling C, Humm J |
Journal | Int J Radiat Oncol Biol Phys |
Volume | 75 |
Issue | 1 |
Pagination | 101-8 |
Date Published | 2009 Sep 01 |
ISSN | 1879-355X |
Keywords | Aged, Antineoplastic Combined Chemotherapy Protocols, Carboplatin, Cell Hypoxia, Cisplatin, Combined Modality Therapy, Fluorouracil, Humans, Laryngeal Neoplasms, Middle Aged, Misonidazole, Oropharyngeal Neoplasms, Positron-Emission Tomography, Prospective Studies, Radiopharmaceuticals, Radiotherapy Dosage, Radiotherapy, Intensity-Modulated, Tomography, X-Ray Computed, Tumor Burden |
Abstract | PURPOSE: To report the results from a prospective study of a series of locoregionally advanced head-and-neck cancer patients treated with platinum-based chemotherapy and intensity-modulated radiotherapy and to discuss the findings of their pre-/mid-treatment [(18)F]-misonidazole ((18)F-FMISO) positron emission tomography (PET) scans. METHODS AND MATERIALS: A total of 28 patients agreed to participate in this study. Of these 28 patients, 20 (90% with an oropharyngeal primary cancer) were able to undergo the requirements of the protocol. Each patient underwent four PET scans: one pretreatment fluorodeoxyglucose PET/computed tomography scan, two pretreatment (18)F-FMISO PET/computed tomography scans, and a third (18)F-FMISO PET (mid-treatment) scan performed 4 weeks after the start of chemoradiotherapy. The (18)F-FMISO PET scans were acquired 2-3 h after tracer administration. Patients were treated with 2-3 cycles of platinum-based chemotherapy concurrent with definitive intensity-modulated radiotherapy. RESULTS: A heterogeneous distribution of (18)F-FMISO was noted in the primary and/or nodal disease in 90% of the patients. Two patients had persistent detectable hypoxia on their third mid-treatment (18)F-FMISO PET scan. One patient experienced regional/distant failure but had no detectable residual hypoxia on the mid-treatment (18)F-FMISO PET scan. CONCLUSION: Excellent locoregional control was observed in this series of head-and-neck cancer patients treated with concurrent platinum-based chemotherapy and intensity-modulated radiotherapy despite evidence of detectable hypoxia on the pretreatment (18)F-FMISO PET/computed tomography scans of 18 of 20 patients. In this prospective study, neither the presence nor the absence of hypoxia, as defined by positive (18)F-FMISO findings on the mid-treatment PET scan, correlated with patient outcome. The results of this study have confirmed similar results reported previously. |
DOI | 10.1016/j.ijrobp.2008.10.049 |
Alternate Journal | Int J Radiat Oncol Biol Phys |
PubMed ID | 19203843 |
PubMed Central ID | PMC2840255 |
Grant List | P01 CA115675 / CA / NCI NIH HHS / United States P01 CA115675-040001 / CA / NCI NIH HHS / United States |