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

Radiother Oncol. 2006 Jul;80(1):51-6. doi: 10.1016/j.radonc.2006.06.001. Epub 2006 Jul 3.

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.

MeSH terms

  • 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
  • Oxygen / metabolism*
  • Positron-Emission Tomography
  • Prognosis
  • Radiopharmaceuticals / pharmacokinetics*
  • Radiotherapy Planning, Computer-Assisted / methods

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18
  • Niacinamide
  • Carbon
  • Oxygen