Assessing tumor hypoxia in cervical cancer by positron emission tomography with 60Cu-ATSM:: Relationship to therapeutic response -: A preliminary report

被引:280
作者
Dehdashti, F
Grigsby, PW
Mintun, MA
Lewis, JS
Siegel, BA
Welch, MJ
机构
[1] Edward Mallinckrodt Inst Radiol, Div Nucl Med, St Louis, MO 63110 USA
[2] Edward Mallinckrodt Inst Radiol, Div Radiol Sci, St Louis, MO 63110 USA
[3] Edward Mallinckrodt Inst Radiol, Dept Radiat Oncol, St Louis, MO 63110 USA
[4] Washington Univ, Sch Med, Siteman Canc Ctr, St Louis, MO 63110 USA
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2003年 / 55卷 / 05期
关键词
positron emission tomography; Cu-60-ATSM; hypoxia; cervical cancer; response to therapy;
D O I
10.1016/S0360-3016(02)04477-2
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: Tumor hypoxia is associated with poor response to therapy. We have investigated whether pretreatment tumor hypoxia assessed by positron emission tomography (PET) with Cu-60 diacetyl-bis(N-4-methylthiosemicarbazone) (Cu-60-ATSM) predicts responsiveness to subsequent therapy in cervical cancer. Methods and Materials: Fourteen patients with biopsy-proved cervical cancer,were studied by PET with Cu-60-ATSM before initiation of radiotherapy and chemotherapy. (CU)-C-60-ATSM uptake was evaluated semiquantitatively by determining the tumor-to-muscle activity ratio (T/M) and peak slope index of tumor tracer uptake. All patients also underwent clinical PET with F-18 fluorodeoxyglucose (FDG) before institution of therapy. The PET results were correlated with follow-up evaluation (14-24 months). Results: Tumor uptake of Cu-60-ATSM was inversely related to progression-free 'u`rvival and overall survival (log-rank p = 0.0005 and p = 0.015, respectively). An arbitrarily selected T/M threshold of 3.5 discriminated those likely to develop recurrence; 6 of 9 patients with normoxic tumors (T/M < 3.5) are free of disease at last follow-up, whereas all of 5 patients with hypoxic tumors (T/M > 3.5) have already developed recurrence. Similar discrimination was achieved with the peak slope index. The frequency of locoregional nodal metastasis was greater in hypoxic tumors (p = 0.03). Tumor FDG uptake did not correlate with 60CU-ATSM uptake (r = 0.04; p = 0.80), and there was no significant difference in tumor FDG uptake between patients with hypoxic tumors and those with normoxic tumors. Conclusion: (CU)-C-60-ATSM-PET in patients with cervical cancer revealed clinically relevant information about tumor oxygenation that was predictive of tumor behavior and response to therapy in this small study. (C) 2003 Elsevier Science Inc.
引用
收藏
页码:1233 / 1238
页数:6
相关论文
共 34 条
  • [1] Performance evaluation of the whole-body PET scanner ECAT EXACT HR+ following the IEC standard
    Adam, LE
    Zaers, J
    Ostertag, H
    Trojan, H
    Bellemann, ME
    Brix, G
    [J]. IEEE TRANSACTIONS ON NUCLEAR SCIENCE, 1997, 44 (03) : 1172 - 1179
  • [2] Bass L. A., 1997, Journal of Labelled Compounds and Radiopharmaceuticals, V40, P325
  • [3] Brizel DM, 1996, CANCER RES, V56, P5347
  • [4] Brown JM, 1999, CANCER RES, V59, P5863
  • [5] Brown JM, 1998, CANCER RES, V58, P1408
  • [6] Burgman P, 2001, J NUCL MED, V42, P170
  • [7] CLAVO AC, 1995, J NUCL MED, V36, P1625
  • [8] Fujibayashi Y, 1997, J NUCL MED, V38, P1155
  • [9] Cervix cancer oxygenation measured following external radiation therapy
    Fyles, AW
    Milosevic, M
    Pintilie, M
    Hill, RP
    [J]. INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1998, 42 (04): : 751 - 753
  • [10] Hypoxia-mediated selection of cells with diminished apoptotic potential in solid tumours
    Graeber, TG
    Osmanian, C
    Jacks, T
    Housman, DE
    Koch, CJ
    Lowe, SW
    Giaccia, AJ
    [J]. NATURE, 1996, 379 (6560) : 88 - 91