Details

Autor(en) / Beteiligte

• Inada, Masahiro
• Nishimura, Yasumasa
• Hanaoka, Kohei
• Nakamatsu, Kiyoshi
• Doi, Hiroshi
• Uehara, Takuya
• Komanishi, Mikihito
• Ishii, Kazunari
• Kaida, Hayato
• Hosono, Makoto

Titel

Visualization of tumor hypoxia and re-oxygenation after stereotactic body radiation therapy in early peripheral lung cancer: A prospective study

Ist Teil von

• Radiotherapy and oncology, 2023-03, Vol.180, p.109491, Article 109491

Ort / Verlag

Ireland: Elsevier B.V

Erscheinungsjahr

2023

Link zum Volltext

Quelle

Elsevier ScienceDirect Journals Complete

Beschreibungen/Notizen

• •・Impact of tumor hypoxia and reoxygenation is unclear in area of lung SBRT.•・Hypoxia and reoxygenation were visualized using F-MISO PET in the prospective study.•・F-MISO uptake tended to increase 1–2 day after SBRT and decrease 3 day after SBRT.•・Pre-treatment F-MISO tumor-muscle ratio > 1.48 were associated with worse PFS.•・Adjuvant therapy may be indicated for F-MISO positive patients to prevent metastasis. In this study, fluoromisonidazole positron emission tomography (F-MISO PET/CT) was used to evaluate tumor hypoxia and re-oxygenation in patients with lung tumors treated with stereotactic body radiation therapy (SBRT). Patients with T1-2 N0 lung cancer were included in this study. The prescribed dose was 48–52 Gy in four fractions. F-MISO PET/CT was performed twice, before SBRT and 1–3 days after the first irradiation. The maximum standardized uptake value (SUVmax) and tumor/muscle ratio (TMR) were evaluated as indicators of hypoxia. The threshold for hypoxia was defined as a TMR of 1.30 or more. Between 2016 and 2021, 15 patients were included. Pre-treatment tumor hypoxia was observed in nine tumors (60 %). TMR in all six tumors without pre-treatment hypoxia rose after single high-dose irradiation. In contrast, TMR in six of nine tumors with pre-treatment hypoxia dropped after irradiation, suggesting re-oxygenation. Although no local recurrence was noted, regional and/or distant relapses were seen in four patients (27 %). Of these, three had tumors with abnormal F-MISO uptake. The remaining patient had a tumor without signs of hypoxia on pre-treatment PET/CT. The 2-year progression free survival of patients with tumors with and without pre-treatment hypoxia were 30 % and 63 %, respectively (p = 0.319). Tumor hypoxia reduced after single high-dose irradiation. Tumor with F-MISO uptake seems to be an unfavorable prognostic factor in lung SBRT.