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European Journal of Nuclear Medicine and Molecular Imaging

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07.12.2019 | Original Article

Correlative analyses between tissue-based hypoxia biomarkers and hypoxia PET imaging in head and neck cancer patients during radiochemotherapy—results from a prospective trial

verfasst von: Nils H. Nicolay, Nicole Wiedenmann, Michael Mix, Wolfgang A. Weber, Martin Werner, Anca L. Grosu, Gian Kayser

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 5/2020

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Abstract

Purpose

Tumor hypoxia impairs the response of head-and-neck cancer (HNSCC) patients to radiotherapy and can be detected both by tissue biomarkers and PET imaging. However, the value of hypoxia biomarkers and imaging for predicting HNSCC patient outcomes are incompletely understood, and potential correlations between tissue and PET data remain to be elucidated. Here, we performed exploratory analyses of potential correlations between tissue-based hypoxia biomarkers and longitudinal hypoxia imaging in a prospective trial of HNSCC patients.

Methods

Forty-nine patients undergoing chemoradiation for locally advanced HNSCCs were enrolled in this prospective trial. They underwent baseline biopsies and [¹⁸F]FDG PET imaging and [¹⁸F]FMISO PET at weeks 0, 2, and 5 during treatment. Immunohistochemical analyses for p16, Ki67, CD34, HIF1α, CAIX, Ku80, and CD44 were performed, and HPV status was assessed. Biomarker expression was correlated with biological imaging information and patient outcome data.

Results

High HIF1α tumor levels significantly correlated with increased tumor hypoxia at week 2 as assessed by the difference in the [¹⁸F]FMISO tumor-to-background ratios, and high HIF1α and CAIX expressions were both associated with a deferred decrease in hypoxia between weeks 2 and 5. Loco-regional recurrence rates after radiotherapy were significantly higher in patients with high CAIX expression and also increased for high levels of the DNA repair factor Ku80. HPV status did not correlate with any of the tested hypoxia biomarkers, and HPV-positive patients showed higher loco-regional control rates and progression-free survival independent of their hypoxia dynamics.

Conclusion

In this exploratory trial, high expression of the tissue-based hypoxia biomarkers HIF1α and CAIX correlated with adverse hypoxia dynamics in HNSCCs during chemoradiation as assessed by PET imaging, and high CAIX levels were associated with increased loco-regional recurrence rates. Hence, hypoxia biomarkers warrant further investigations as potential predictors of hypoxia dynamics and hypoxia-associated radiation resistance.

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Titel: Correlative analyses between tissue-based hypoxia biomarkers and hypoxia PET imaging in head and neck cancer patients during radiochemotherapy—results from a prospective trial
verfasst von: Nils H. Nicolay
Nicole Wiedenmann
Michael Mix
Wolfgang A. Weber
Martin Werner
Anca L. Grosu
Gian Kayser
Publikationsdatum: 07.12.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 5/2020
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-019-04598-9

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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