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000166144 1001_ $$0P:(DE-HGF)0$$aZschaeck, Sebastian$$b0
000166144 245__ $$aGeneration of biological hypotheses by functional imaging links tumor hypoxia to radiation induced tissue inflammation/glucose uptake in head and neck cancer.
000166144 260__ $$aAmsterdam [u.a.]$$bElsevier Science$$c2020
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000166144 520__ $$aPositron emission tomography (PET) is a functional imaging modality which is able to deliver tracer specific biological information, e.g. about glucose uptake, inflammation or hypoxia of tumors. We performed a proof-of-principle study that used different tracers and expanded the analytical scope to non-tumor structures to evaluate tumor-host interactions.Based on a previously reported prospective imaging study on 50 patients treated with curative intent chemoradiation (CRT) for head and neck squamous cell carcinoma, PET-based hypoxia and normal tissue inflammation measured by repeat 18F-fluoromisonidazole (FMISO) PET and 18F-fluorodesoxyglucose (FDG) PET, respectively, were correlated using the Spearman correlation coefficient R. PET parameters determined before and during CRT (week 1, 2 and 5), were associated with local tumor control and overall survival.Tumor hypoxia at all measured times showed an inverse correlation with mid-treatment FDG-uptake of non-tumor affected oral (sub-)mucosa with R values between -0.35 and -0.6 (all p < 0.05). Mucosal FDG-uptake and mucosal hypoxia correlated positively but weaker (R values between 0.2 and 0.45). More tumor hypoxia in FMISO-PET (week 2) and less FDG-uptake of (sub-)mucosa in FDG-PET (week 4) were significantly associated with worse LC (FMISO TBRpeak: HR = 1.72, p = 0.030; FDG SUVmean: HR = 0.23, p = 0.025) and OS (FMISO TBRpeak: HR = 1.71, p = 0.007; FDG SUVmean: HR = 0.30, p = 0.003). Multivariable models including both parameters showed improved performance, suggesting that these modalities still bear distinct biological information despite their strong inter-correlation.We report first clinical evidence that tumor hypoxia is inversely correlated with increased FDG-uptake during radiation, potentially expressing inflammation. This observation merits further research and may have important implication for future research on tumor hypoxia and radio-immunology. Our study demonstrates that functional imaging can be utilized to assess complex tumor-host interactions and generate novel biological insights in vivo vero.
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000166144 7001_ $$0P:(DE-HGF)0$$aZöphel, Klaus$$b1
000166144 7001_ $$0P:(DE-HGF)0$$aSeidlitz, Annekatrin$$b2
000166144 7001_ $$0P:(DE-HGF)0$$aZips, Daniel$$b3
000166144 7001_ $$0P:(DE-HGF)0$$aKotzerke, Jörg$$b4
000166144 7001_ $$0P:(DE-He78)933f7d725ac87378f459623783585a1f$$aBaumann, Michael$$b5$$udkfz
000166144 7001_ $$0P:(DE-He78)91d4b4a1e36e2bec6c08ac43e6820834$$aTroost, Esther$$b6$$udkfz
000166144 7001_ $$0P:(DE-HGF)0$$aLöck, Steffen$$b7
000166144 7001_ $$0P:(DE-He78)4be9ccb23f3e472b97743845cd2b3fe9$$aKrause, Mechthild$$b8$$udkfz
000166144 773__ $$0PERI:(DE-600)1500707-8$$a10.1016/j.radonc.2020.10.030$$gVol. 155, p. 204 - 211$$p204 - 211$$tRadiotherapy and oncology$$v155$$x0167-8140$$y2020
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