Effects of hyperoxygenation on FDG-uptake in head-and-neck cancer.

Abstract

PURPOSE:

Tumor hyperoxygenation results in high response rates to ARCON (accelerated radiotherapy with carbogen and nicotinamide). The effect of hyperoxygenation on tumor metabolism using [(18)F]fluorodeoxyglucose (FDG) positron emission tomography (PET) was investigated.

METHODS:

Within one week, FDG-PET was performed without and with hyperoxygenation by carbogen breathing and/or nicotinamide administration in 22 patients, eligible for ARCON for head-and-neck cancer. Maximum standardized uptake values (SUV(max)) in both scans and the relative change were calculated in the primary tumor and in normal muscle.

RESULTS:

Alteration of the tumor oxygenation state induced profound, but variable, metabolic changes (median DeltaSUV(max) -4%; range -61% to +30%). Metabolism in normal muscle was not affected. In three patients who did not achieve local tumor control, the SUV(max) after hyperoxygenation differed less than 5% change as compared to baseline, whereas 13 of the 16 patients with local tumor control showed a larger difference (p<0.05).

CONCLUSION:

Given the heterogeneous response pattern of nicotinamide and carbogen on FDG-uptake in head-and-neck carcinoma, the prognostic significance of semiquantitative FDG-PET before and after hyperoxygenation remains uncertain and requires confirmation in larger clinical studies before introducing the procedure as a predictive tool for oxygenation modifying treatments.

• Authors: Lioe-Fee de Geus-Oei, Johannes H A M Kaanders, Luc A M Pop, Frans H M Corstens, Wim J G Oyen
• Journal: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology (Radiother Oncol) Vol. 80 Issue 1 Pg. 51-6 (Jul 2006) ISSN: 0167-8140 [Print] Ireland
• PMID: 16820237 (Publication Type: Journal Article)

Chemical References

• Radiopharmaceuticals
• Fluorodeoxyglucose F18
• Niacinamide
• Carbon
• Oxygen

Topics

• Aged
• Aged, 80 and over
• Carbon (chemistry)
• Female
• Fluorodeoxyglucose F18 (pharmacokinetics)
• Head and Neck Neoplasms (diagnostic imaging)
• Humans
• Male
• Middle Aged
• Niacinamide (chemistry)
• Oxygen (chemistry, metabolism)
• Positron-Emission Tomography
• Prognosis
• Radiopharmaceuticals (pharmacokinetics)
• Radiotherapy Planning, Computer-Assisted (methods)