Hypoxia Dose Painting by Numbers: A Planning Study

Thorwarth, Daniela; Eschmann, S. M.; Paulsen, Frank; Alber, M.

doi:10.1016/j.ijrobp.2006.11.061

Cited by 262 publications

(188 citation statements)

References 27 publications

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“…However, our data supports the need to explore this as the majority of failures mapped to the pretreatment PET abnormality. Others have previously shown that dose escalation of the PET abnormality is feasible in select patients [24,30,31]. Such areas could be part of a simultaneous integrated boost [32,33].…”

Section: Discussionmentioning

confidence: 99%

Correlation between pretreatment FDG-PET biological target volume and anatomical location of failure after radiation therapy for head and neck cancers

Soto¹,

Kessler²,

Piert³

et al. 2008

Radiotherapy and Oncology

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Section: Discussionmentioning

confidence: 99%

Correlation between pretreatment FDG-PET biological target volume and anatomical location of failure after radiation therapy for head and neck cancers

Soto¹,

Kessler²,

Piert³

et al. 2008

Radiotherapy and Oncology

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“…Significant hypoxia was present in 58 patients (79%), and both the degree of hypoxia and the size of the hypoxic volume were independent predictive factors for survival (10). These data imply that 18 F-fluoromisonidazole PET can be used to estimate the burden of hypoxia in HNSCC and can provide a promising target for dose painting (11,12).…”

mentioning

confidence: 81%

Dose Painting in Radiotherapy for Head and Neck Squamous Cell Carcinoma: Value of Repeated Functional Imaging with¹⁸F-FDG PET,¹⁸F-Fluoromisonidazole PET, Diffusion-Weighted MRI, and Dynamic Contrast-Enhanced MRI

Dirix¹,

Vandecaveye²,

Keyzer³

et al. 2009

J Nucl Med

190

108

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The purpose of this work was to evaluate the potential of functional imaging with 18 F-FDG PET, 18 F-fluoromisonidazole PET, diffusion-weighted MRI, and dynamic contrast-enhanced MRI to provide an appropriate and reliable biologic target for dose painting in radiotherapy for head and neck squamous cell carcinoma (HNSCC). Methods: Fifteen patients with locally advanced HNSCC, treated with concomitant chemoradiotherapy, were prospectively enrolled in a bioimaging protocol. Sequential PET ( 18 F-FDG and 18 F-fluoromisonidazole) and MRI (T1, T2, dynamic enhanced, and diffusion-weighted sequences) were performed before, during, and after radiotherapy. Results: Median follow-up was 30.7 mo (range, 6.3-56.3 mo); in 7 patients, disease recurred. Disease-free survival correlated negatively with the maximum tissue-to-blood 18 F-fluoromisonidazole ratio (T/B max ) on the baseline 18 F-fluoromisonidazole scan (P 5 0.04), with the size of the initial hypoxic volume (P 5 0.04), and with T/B max on the 18 F-fluoromisonidazole scan during treatment (P 5 0.02). All locoregional recurrences were within the 18 F-FDGavid regions on baseline 18 F-FDG PET; 3 recurrences mapped outside the hypoxic volume on baseline 18 F-fluoromisonidazole PET. Lesions (primary tumor and lymph nodes) where a locoregional recurrence developed during follow-up had significantly lower apparent diffusion coefficients on diffusion-weighted MRI during week 4 of radiotherapy (0.0013 vs. 0.0018 mm 2 /s, P 5 0.01) and at 3 wk after treatment (0.0014 vs. 0.0018 mm 2 /s, P 5 0.01) and a significantly higher initial slope on baseline dynamic enhanced MRI (26.2 vs. 17.5/s, P 5 0.03) than did lesions that remained controlled. Conclusion: These results confirm the added value of 18 F-FDG PET and 18 F-fluoromisonidazole PET for radiotherapy planning of HNSCC and suggest the potential of diffusion-weighted and dynamic enhanced MRI for dose painting and early response assessment.

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“…Several strategies for dose-painting approaches based on hypoxia in head and neck tumours have been proposed and they are under various stages of validation. Among them one could mention the planning study by Thorwarth et al [71] on dose escalation to head and neck hypoxic subvolumes based on PET imaging which was followed by a still ongoing clinical trial and the dose prescription and treatment planning method based on hypoxia PET imaging proposed by Toma-Dasu et al [72] which is currently under clinical validation.…”

Section: Reoxygenationmentioning

confidence: 99%

The Six Rs of Head and Neck Cancer Radiotherapy

Marcu¹,

Toma-Daşu²,

Daşu³

2015

Contemporary Issues in Head and Neck Cancer Management

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Hypoxia Dose Painting by Numbers: A Planning Study

Cited by 262 publications

References 27 publications

Correlation between pretreatment FDG-PET biological target volume and anatomical location of failure after radiation therapy for head and neck cancers

Correlation between pretreatment FDG-PET biological target volume and anatomical location of failure after radiation therapy for head and neck cancers

Dose Painting in Radiotherapy for Head and Neck Squamous Cell Carcinoma: Value of Repeated Functional Imaging with¹⁸F-FDG PET,¹⁸F-Fluoromisonidazole PET, Diffusion-Weighted MRI, and Dynamic Contrast-Enhanced MRI

The Six Rs of Head and Neck Cancer Radiotherapy

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Hypoxia Dose Painting by Numbers: A Planning Study

Cited by 262 publications

References 27 publications

Correlation between pretreatment FDG-PET biological target volume and anatomical location of failure after radiation therapy for head and neck cancers

Correlation between pretreatment FDG-PET biological target volume and anatomical location of failure after radiation therapy for head and neck cancers

Dose Painting in Radiotherapy for Head and Neck Squamous Cell Carcinoma: Value of Repeated Functional Imaging with18F-FDG PET,18F-Fluoromisonidazole PET, Diffusion-Weighted MRI, and Dynamic Contrast-Enhanced MRI

The Six Rs of Head and Neck Cancer Radiotherapy

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Resources

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Dose Painting in Radiotherapy for Head and Neck Squamous Cell Carcinoma: Value of Repeated Functional Imaging with¹⁸F-FDG PET,¹⁸F-Fluoromisonidazole PET, Diffusion-Weighted MRI, and Dynamic Contrast-Enhanced MRI