Prognostic value of dynamic hypoxia PET in head and neck cancer

• Verfasst von: Welz, Stefan [VerfasserIn]
• Verfasst von: Alber, Markus [VerfasserIn]
• Titel: Prognostic value of dynamic hypoxia PET in head and neck cancer
• Titelzusatz: results from a planned interim analysis of a randomized phase II hypoxia-image guided dose escalation trial ; parts of this work were presented at the Meeting of the European Society for Therapeutic Radiology and Oncology (ESTRO 33), Vienna, Austria, 4-8th April 2014
• Verf.angabe: Stefan Welz, David Mönnich, Christina Pfannenberg, Konstantin Nikolaou, Mathias Reimold, Christian La Fougère, Gerald Reischl, Paul-Stefan Mauz, Frank Paulsen, Markus Alber, Claus Belka, Daniel Zips, Daniela Thorwarth
• E-Jahr: 2017
• Jahr: 20 April 2017
• Umfang: 7 S.
• Fussnoten: Gesehen am 26.11.2018
• Titel Quelle: Enthalten in: Radiotherapy and oncology
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1983
• Jahr Quelle: 2017
• Band/Heft Quelle: 124(2017), 3, Seite 526-532
• ISSN Quelle: 1879-0887
• DOI: doi:10.1016/j.radonc.2017.04.004
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Dose escalation
• Sach-SW: FMISO PET/CT
• Sach-SW: Head and neck cancer
• Sach-SW: Hypoxia
• Sach-SW: IMRT
• K10plus-PPN: 1584419717

Abstract

Background and purpose: To prospectively assess the prognostic value of tumour hypoxia determined by dynamic [18F]Fluoromisonidazole (dynFMISO) PET/CT, and to evaluate both feasibility and toxicity in patients with locally advanced squamous cell carcinomas of the head and neck (LASCCHN) treated with dynFMISO image-guided dose escalation (DE) using dose-painting by contours. Patients and methods: We present a planned interim analysis of a randomized phase II trial. N=25 patients with LASCCHN received baseline dynFMISO PET/CT to derive hypoxic volumes (HV). Patients with tumour hypoxia were randomized into standard radiochemotherapy (stdRT) (70Gy/35 fractions) or DE (77Gy/35 fractions) to the HV. Patients with non-hypoxic tumours were treated with stdRT. Loco-regional control (LRC) in hypoxic patients randomized to stdRT was compared to non-hypoxic patients. Feasibility and toxicity were analysed for patients in the DE arm and compared to stdRT. Results: With a mean follow-up of 27months, LRC in hypoxic patients receiving stdRT (n=10) was significantly worse compared to the non-hypoxic group (n=5) (2y-LRC 44.4% versus 100%, p=0.048). The respective LRC for the DE group (n=10) was 70.0%. Treatment compliance as well as acute and late toxicity did not show significant differences between the DE and the standard dose arms. Conclusion Tumour hypoxia determined by baseline dynFMISO PET/CT is associated with a high risk of local failure in patients with LASCCHN. First data suggest that DE to HV is feasible without excess toxicity.