The influence of changes in tumor hypoxia on dose-painting treatment plans based on (18)F-FMISO positron emission tomography Journal Article
| Authors: | Lin, Z.; Mechalakos, J.; Nehmeh, S.; Schoder, H.; Lee, N.; Humm, J.; Ling, C. C. |
| Article Title: | The influence of changes in tumor hypoxia on dose-painting treatment plans based on (18)F-FMISO positron emission tomography |
| Abstract: | Purpose: To evaluate how changes in tumor hypoxia, according to serial fluorine-18-labeled fluoro-misonidazole (18F-FMISO) positron emission tomography (PET) imaging, affect the efficacy of intensity-modulated radiotherapy (IMRT) dose painting. Methods and Materials: Seven patients with head and neck cancers were imaged twice with FMISO PET, separated by 3 days, before radiotherapy. Intensity-modulated radiotherapy plans were designed, on the basis of the first FMISO scan, to deliver a boost dose of 14 Gy to the hypoxic volume, in addition to the 70-Gy prescription dose. The same plans were then applied to hypoxic volumes from the second FMISO scan, and the efficacy of dose painting evaluated by assessing coverage of the hypoxic volumes using Dmax, Dmin, Dmean, D95, and equivalent uniform dose (EUD). Results: Similar hypoxic volumes were observed in the serial scans for 3 patients but dissimilar ones for the other 4. There was reduced coverage of hypoxic volumes of the second FMISO scan relative to that of the first scan (e.g., the average EUD decreased from 87 Gy to 80 Gy). The decrease was dependent on the similarity of the hypoxic volumes of the two scans (e.g., the average EUD decrease was approximately 4 Gy for patients with similar hypoxic volumes and approximately 12 Gy for patients with dissimilar ones). Conclusions: The changes in spatial distribution of tumor hypoxia, as detected in serial FMISO PET imaging, compromised the coverage of hypoxic tumor volumes achievable by dose-painting IMRT. However, dose painting always increased the EUD of the hypoxic volumes. © 2008 Elsevier Inc. All rights reserved. |
| Keywords: | clinical article; controlled study; intensity modulated radiation therapy; treatment planning; positron emission tomography; follow-up studies; tumor volume; radiotherapy dosage; radiotherapy; hypoxia; head and neck cancer; medical imaging; tumors; feasibility studies; head and neck neoplasms; radiotherapy, intensity-modulated; positron-emission tomography; 1 fluoro 3 (2 nitro 1 imidazolyl) 2 propanol f 18; cell hypoxia; misonidazole; radiotherapy planning, computer-assisted; radiation-sensitizing agents; radiation dose distribution; tumor hypoxia; radiation tolerance; 18f-fmiso pet; dose painting; hypoxic volumes |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 70 |
| Issue: | 4 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2008-03-15 |
| Start Page: | 1219 |
| End Page: | 1228 |
| Language: | English |
| DOI: | 10.1016/j.ijrobp.2007.09.050 |
| PUBMED: | 18313529 |
| PROVIDER: | scopus |
| PMCID: | PMC3784985 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 42" - "Export Date: 17 November 2011" - "CODEN: IOBPD" - "Source: Scopus" |
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