Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/11649
Title: Hypoxia-targeted radiotherapy dose painting for head and neck cancer using (18)F-FMISO PET: a biological modeling study.
Authors: Chang, Joe H;Wada, Morikatsu;Anderson, Nigel J;Lim Joon, Daryl;Lee, Sze Ting;Gong, Sylvia J;Gunawardana, Dishan H;Sachinidis, John;O'Keefe, Graeme J;Gan, Hui K;Khoo, Vincent;Scott, Andrew M
Affiliation: Radiation Oncology Centre , Austin Health, Victoria , Australia.
Issue Date: 15-Jan-2013
Citation: Acta Oncologica (stockholm, Sweden) 2013; 52(8): 1723-9
Abstract: This study investigates the use of (18)F-fluoromisonidazole (FMISO) PET-guided radiotherapy dose painting for potentially overcoming the radioresistant effects of hypoxia in head and neck squamous cell carcinoma (HNSCC).The study cohort consisted of eight patients with HNSCC who were planned for definitive radiotherapy. Hypoxic subvolumes were automatically generated on pre-radiotherapy FMISO PET scans. Three radiotherapy plans were generated for each patient: a standard (STD) radiotherapy plan to a dose of 70 Gy, a uniform dose escalation (UDE) plan to the standard target volumes to a dose of 84 Gy, and a hypoxia dose-painted (HDP) plan with dose escalation only to the hypoxic subvolume to 84 Gy. Plans were compared based on tumor control probability (TCP), normal tissue complication probability (NTCP), and uncomplicated tumor control probability (UTCP).The mean TCP increased from 73% with STD plans to 95% with the use of UDE plans (p < 0.001) and to 93% with HDP plans (p < 0.001). The mean parotid NTCP increased from 26% to 44% with the use of UDE plans (p = 0.003), and the mean mandible NTCP increased from 2% to 27% with the use of UDE plans (p = 0.001). There were no statistically significant differences between any of the NTCPs between the STD plans and HDP plans. The mean UTCP increased from 48% with STD plans to 66% with HDP plans (p = 0.016) and dropped to 37% with UDE plans (p = 0.138).Hypoxia-targeted radiotherapy dose painting for head and neck cancer using FMISO PET is technically feasible, increases the TCP without increasing the NTCP, and increases the UTCP. This approach is superior to uniform dose escalation.
Internal ID Number: 23317145
URI: http://ahro.austin.org.au/austinjspui/handle/1/11649
DOI: 10.3109/0284186X.2012.759273
URL: http://www.ncbi.nlm.nih.gov/pubmed/23317145
Type: Journal Article
Subjects: Adult
Aged
Carcinoma, Squamous Cell.pathology.radionuclide imaging.radiotherapy
Cell Hypoxia
Cohort Studies
Fluorodeoxyglucose F18.diagnostic use
Follow-Up Studies
Head and Neck Neoplasms.pathology.radionuclide imaging.radiotherapy
Humans
Male
Middle Aged
Misonidazole.analogs & derivatives.diagnostic use
Models, Biological
Neoplasm Staging
Positron-Emission Tomography
Prognosis
Radiopharmaceuticals.diagnostic use
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted
Radiotherapy, Intensity-Modulated
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