Liu Mingyu, Ma Ningyi, Chen Jian, Ren Caiyue, Zhang Fuquan, Mao Jingfang, Wu Kailiang, Jiang Guoliang, Sun Yun, Song Shaoli, Cheng Jingyi
Abstract
ObjectiveTo explore the clinical value of 18F-fluoromisonidazole (FMISO) PET/CT hypoxia imaging in early response to heavy ion radiotherapy in patients with non-small cell lung cancer(NSCLC).
MethodsFrom April 2018 to January 2021, the 18F-FMISO PET/CT images of 23 NSCLC patients (19 males, 4 females; age (64.9±10.3) years) who received heavy ion radiotherapy in Shanghai Proton and Heavy Ion Center were retrospectively analyzed. The evaluation parameters included tumor volume (TV), tumor to background ratio (TBR) before and after radiotherapy. Patients were divided into hypoxia group and non-hypoxia group with the baseline TBR value≥1.4 as hypoxia threshold. Wilcoxon signed rank test was used to compare the differences of TV and TBR before and after radiotherapy in 2 groups.
ResultsOf 23 NSCLC patients, 17 were hypoxia and 6 were non-hypoxia. Compared with the baseline, TV after the radiotherapy (59.44(22.86, 99.43) and 33.78(8.68, 54.44) cm3; z=-3.05, P=0.002) and TBR after the radiotherapy (2.25(2.09, 2.82) and 1.42(1.24, 1.67); z=-3.39, P=0.001) of the hypoxia group were significantly lower, while TV (16.19(6.74, 36.52) and 8.59(4.38, 25.47) cm3; z=-1.57, P=0.120) and TBR (1.19(1.05, 1.27) and 1.10 (0.97, 1.14); z=-1.89, P=0.060) of the non-hypoxia group decreased with no significant differences.
ConclusionsHypoxic NSCLC tumors are sensitive to heavy ion radiation. Compared with non-hypoxic tumors, hypoxic tumors respond more quickly, and a significant reduction in TV can be observed early after radiotherapy. Heavy ion radiation can significantly improve tumor hypoxia.
Key words:
Carcinoma, non-small-cell lung; Heavy ion radiotherapy; Misonidazole; Hypoxia; Positron-emission tomography; Tomography, X-ray computed
Contributor Information
Liu Mingyu
Department of Nuclear Medicine, Fudan University Shanghai Cancer Center
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
Ma Ningyi
Department of Radiotherapy, Shanghai Proton and Heavy Ion Center, Shanghai Key Laboratory of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai 201321, China
Chen Jian
Department of Radiotherapy, Shanghai Proton and Heavy Ion Center, Shanghai Key Laboratory of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai 201321, China
Ren Caiyue
Department of Nuclear Medicine, Shanghai Proton and Heavy Ion Center, Shanghai Key Laboratory of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai 201321, China
Zhang Fuquan
Department of Nuclear Medicine, Shanghai Proton and Heavy Ion Center, Shanghai Key Laboratory of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai 201321, China
Mao Jingfang
Department of Radiotherapy, Shanghai Proton and Heavy Ion Center, Shanghai Key Laboratory of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai 201321, China
Wu Kailiang
Department of Radiotherapy, Shanghai Proton and Heavy Ion Center, Shanghai Key Laboratory of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai 201321, China
Jiang Guoliang
Department of Radiotherapy, Shanghai Proton and Heavy Ion Center, Shanghai Key Laboratory of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai 201321, China
Sun Yun
Department of Nuclear Medicine, Shanghai Proton and Heavy Ion Center, Shanghai Key Laboratory of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai 201321, China
Song Shaoli
Department of Nuclear Medicine, Fudan University Shanghai Cancer Center
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
Cheng Jingyi
Department of Nuclear Medicine, Fudan University Shanghai Cancer Center
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
