Prospective Trial Incorporating Pre-/Mid-Treatment [(18)F]-Misonidazole Positron Emission Tomography for Head-and-Neck Cancer Patients Undergoing Concurrent Chemoradiotherapy Journal Article
| Authors: | Lee, N.; Nehmeh, S.; Schoder, H.; Fury, M.; Chan, K.; Ling, C. C.; Humm, J. |
| Article Title: | Prospective Trial Incorporating Pre-/Mid-Treatment [(18)F]-Misonidazole Positron Emission Tomography for Head-and-Neck Cancer Patients Undergoing Concurrent Chemoradiotherapy |
| 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. © 2009 Elsevier Inc. All rights reserved. |
| Keywords: | adult; cancer survival; clinical article; controlled study; aged; middle aged; intensity modulated radiation therapy; laryngeal neoplasms; cisplatin; fluorouracil; advanced cancer; radiation dose; combined modality therapy; chemotherapy; positron emission tomography; prospective studies; radiopharmaceuticals; carboplatin; multiple cycle treatment; tumor volume; antineoplastic combined chemotherapy protocols; radiotherapy dosage; radiotherapy; tomography, x-ray computed; patient monitoring; hypoxia; head and neck cancer; imrt; intensity-modulated radiotherapy; physical therapy; radiotherapy, intensity-modulated; tumor burden; fluorodeoxyglucose f 18; computer assisted emission tomography; positron-emission tomography; platinum; 1 fluoro 3 (2 nitro 1 imidazolyl) 2 propanol f 18; cell hypoxia; misonidazole; pet; chemoradiotherapy; <sup>18</sup>f-fmiso; f-fmiso; concurrency control; positrons; oropharyngeal neoplasms |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 75 |
| Issue: | 1 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2009-09-01 |
| Start Page: | 101 |
| End Page: | 108 |
| Language: | English |
| DOI: | 10.1016/j.ijrobp.2008.10.049 |
| PUBMED: | 19203843 |
| PROVIDER: | scopus |
| PMCID: | PMC2840255 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 10" - "Export Date: 30 November 2010" - "CODEN: IOBPD" - "Source: Scopus" |
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