201. Assessment of the Tumor Redox Status in Head and Neck Cancer by 62Cu-ATSM PET.
- Author
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Tsujikawa, Tetsuya, Asahi, Satoko, Oh, Myungmi, Sato, Yoshitaka, Narita, Norihiko, Makino, Akira, Mori, Tetsuya, Kiyono, Yasushi, Tsuchida, Tatsuro, Kimura, Hirohiko, Fujieda, Shigeharu, and Okazawa, Hidehiko
- Subjects
TUMOR markers ,HEAD & neck cancer treatment ,CANCER invasiveness ,PROGRESSION-free survival ,KAPLAN-Meier estimator ,CANCER-related mortality - Abstract
Purpose: Tumor redox is an important factor for cancer progression, resistance to treatments, and a poor prognosis. The aim of the present study was to define tumor redox (over-reduction) using
62 Cu-diacetyl-bis(N4 -methylthiosemicarbazone) (62 Cu-ATSM) PET and compare its prognostic potential in head and neck cancer (HNC) with that of 2-deoxy-2-[18 F]fluoro-D-glucose (18 F-FDG). Methods: Thirty HNC patients (stage II–IV) underwent pretreatment62 Cu-ATSM and18 F-FDG PET scans. Maximum standardized uptake values (SUVATSM and SUVFDG ) and tumor-to-muscle activity concentration ratios (TMRATSM and TMRFDG ) were measured. Reductive-tumor-volume (RTV) was then determined at four thresholds (40%, 50%, 60%, and 70% SUVATSM ), and total-lesion-reduction (TLR) was calculated as the product of the mean SUV and RTV for62 Cu-ATSM. In18 F-FDG, metabolic-tumor-volume (MTV) and total-lesion-glycolysis (TLG) were obtained at a threshold of 40%. A ROC analysis was performed to determine % thresholds for RTV and TLR showing the best predictive performance, and these were then used to determine the optimal cut-off values to stratify patients for each parameter. Progression-free-survival (PFS) and cause-specific-survival (CSS) were evaluated by the Kaplan-Meier method. Results: The means ± standard deviations of PFS and CSS periods were 16.4±13.4 and 19.2±12.4 months, respectively. A ROC analysis determined that the 70% SUVATSM threshold for RTV and TLR was the best for predicting disease progression and cancer death. Optimal cut-offs for each index were SUVATSM = 3.6, SUVFDG = 7.9, TMRATSM = 3.2, TMRFDG = 5.6, RTV = 2.9, MTV = 8.1, TLR = 14.0, and TLG = 36.5. When the cut-offs for TMRATSM and TLR were set as described above in62 Cu-ATSM PET, patients with higher TMRATSM (p = 0.03) and greater TLR (p = 0.02) showed significantly worse PFS, while patients with greater TLR had significantly worse CSS (p = 0.02). Only MTV in18 F-FDG PET predicted differences in PSF and CSS (p = 0.03 and p = 0.03, respectively). Conclusion: Tumor redox parameters measured by62 Cu-ATSM PET may be determinants of HNC patient outcomes and help define optimal patient-specific treatments. [ABSTRACT FROM AUTHOR]- Published
- 2016
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