Prognostic value of dynamic hypoxia PET in head and neck cancer: 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
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...
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| Main Authors: | , |
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| Format: | Article (Journal) Conference Paper |
| Language: | English |
| Published: |
20 April 2017
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| In: |
Radiotherapy and oncology
Year: 2017, Volume: 124, Issue: 3, Pages: 526-532 |
| ISSN: | 1879-0887 |
| DOI: | 10.1016/j.radonc.2017.04.004 |
| Online Access: | Verlag, Volltext: http://dx.doi.org/10.1016/j.radonc.2017.04.004 Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S0167814017301445 
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| Author Notes: | 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 |
| Summary: | 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. |
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| Item Description: | Gesehen am 26.11.2018 |
| Physical Description: | Online Resource |
| ISSN: | 1879-0887 |
| DOI: | 10.1016/j.radonc.2017.04.004 |