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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Evaluation of early response to radiotherapy in head and neck cancer measured with (11C)methionine-positron emission tomography.
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Evaluation of early response to radiotherapy in head and neck cancer measured with (11C)methionine-positron emission tomography.

机译：（11C）蛋氨酸-正电子发射断层显像技术评估头颈癌放疗的早期反应。

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PURPOSE: To evaluate whether positron emission tomography (PET) with carbon-11-methionine (MET) can be used for detection of early response to external beam radiotherapy (RT) in untreated head and neck cancer using locoregional control and survival as study endpoints. MATERIALS: Fifteen patients with head and neck cancer underwent a MET PET study before RT and after a median dose of 24 Gy. Fractionation was standard (n = 6) or hyperfractionated (n = 9), and 13 out of 15 patients had planned surgery after RT. SUV was calculated for primary tumor (n = 13) or largest lymph node metastasis in two patients of whom one had his primary excised before study enrollment and one presented with unknown primary tumor syndrome. METHODS: Attenuation corrected PET scans acquired 20-40 min from tracer injection were used for evaluation of MET uptake in tumors. A quantitative MET uptake index was expressed as standardized uptake value (SUV) or SUV(lean) (corrected for lean body mass). The PET results were correlated with clinical follow-up data. The median follow-up time is currently 28 months (range 22-34). RESULTS: A total of 13 primary tumors and 12 metastatic lymph nodes were visually identified in MET PET. In the first PET study the median SUV in tumor was 8.6 (range, 5.5-14.0). In the second PET study performed during RT the median SUV decreased to 5.7 (range, 3.1-8.2, P = 0.001). Two out of 15 patients showed no radiation-induced decrease in SUV. The median tumor SUV ratio of patients remaining in local control (CR) after RT was 0.7 (range 0.6-0.8, n = 6), and that of relapsing patients similarly 0.7 (range 0.5-1.0, n = 9, NS). The SUV ratio was not associated with survival time. The MET uptake of submandibular salivary glands decreased in all patients during the first two or three weeks of RT (P = 0.03). CONCLUSIONS: MET uptake in tumor shows a significant decrease during the first two to three weeks of RT of head and neck cancer. It appears that the rate of decrease in tracer uptake is comparable in relapsing patients and those who remain locally controlled and thus the use of MET PET for prediction of response to RT is limited.
机译：目的：使用局部控制和生存作为研究终点，以评估碳十一蛋氨酸（MET）的正电子发射断层扫描（PET）是否可用于检测未经治疗的头颈癌对外部束放射疗法（RT）的早期反应。材料：15例头颈癌患者在放疗前和中位剂量24 Gy后接受了MET PET研究。分为标准（n = 6）或超分割（n = 9），并且每15例患者中就有13例计划在RT后进行手术。在两名患者中计算了SUV的原发肿瘤（n = 13）或最大淋巴结转移情况，其中一名患者在研究入组前已切除原发，另一名患者患有未知的原发性肿瘤综合征。方法：使用示踪剂注射20-40分钟获得的衰减校正的PET扫描来评估肿瘤中的MET摄取。定量MET摄取指数表示为标准摄取值（SUV）或SUV（瘦肉）（针对瘦肉体重进行校正）。 PET结果与临床随访数据相关。目前的中位随访时间为28个月（范围22-34）。结果：在MET PET中目视鉴定出总共13个原发性肿瘤和12个转移性淋巴结。在第一项PET研究中，肿瘤中的SUV中位数为8.6（范围5.5-14.0）。在RT期间进行的第二项PET研究中，SUV的中位数降至5.7（范围为3.1-8.2，P = 0.001）。 15名患者中有2名显示无辐射引起的SUV降低。放疗后仍留在局部对照（CR）患者中，肿瘤SUV的中位数为0.7（范围0.6-0.8，n = 6），复发患者的中性比例为0.7（范围0.5-1.0，n = 9，NS）。 SUV比率与存活时间无关。在RT的前两周或三周内，所有患者的颌下唾液腺的MET吸收均降低（P = 0.03）。结论：头颈癌放疗的前两至三周，肿瘤中的MET摄取显着降低。在复发患者和那些仍受局部控制的患者中，示踪剂摄取的减少率似乎相当，因此使用MET PET预测对RT的反应受到限制。

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