% IMPORTANT: The following is UTF-8 encoded. This means that in the presence % of non-ASCII characters, it will not work with BibTeX 0.99 or older. % Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or % “biber”. @ARTICLE{Rhle:177407, author = {A. Rühle$^*$ and N. Wiedenmann$^*$ and J. T. Fennell$^*$ and M. Mix and J. Ruf and R. Stoian$^*$ and A. R. Thomsen$^*$ and P. Vaupel$^*$ and D. Baltas$^*$ and A.-L. Grosu$^*$ and N. Nicolay$^*$}, title = {{I}nterleukin-6 as surrogate marker for imaging-based hypoxia dynamics in patients with head-and-neck cancers undergoing definitive chemoradiation-results from a prospective pilot trial.}, journal = {European journal of nuclear medicine and molecular imaging}, volume = {49}, number = {5}, issn = {1619-7089}, address = {Heidelberg [u.a.]}, publisher = {Springer-Verl.}, reportid = {DKFZ-2021-02499}, pages = {1650-1660}, year = {2022}, note = {#EA:E055#LA:E055# / 2022 Apr;49(5):1650-1660}, abstract = {Intratumoral hypoxia increases resistance of head-and-neck squamous cell carcinoma (HNSCC) to radiotherapy. [18F]FMISO PET imaging enables noninvasive hypoxia monitoring, though requiring complex logistical efforts. We investigated the role of plasma interleukin-6 (IL-6) as potential surrogate parameter for intratumoral hypoxia in HNSCC using [18F]FMISO PET/CT as reference.Within a prospective trial, serial blood samples of 27 HNSCC patients undergoing definitive chemoradiation were collected to analyze plasma IL-6 levels. Intratumoral hypoxia was assessed in treatment weeks 0, 2, and 5 using [18F]FMISO PET/CT imaging. The association between PET-based hypoxia and IL-6 was examined using Pearson's correlation and multiple regression analyses, and the diagnostic power of IL-6 for tumor hypoxia response prediction was determined with receiver-operating characteristic analyses.Mean IL-6 concentrations were 15.1, 19.6, and 31.0 pg/mL at baseline, week 2 and week 5, respectively. Smoking (p=0.050) and reduced performance status (p=0.011) resulted in higher IL-6 levels, whereas tumor (p=0.427) and nodal stages (p=0.334), tumor localization (p=0.439), and HPV status (p=0.294) had no influence. IL-6 levels strongly correlated with the intratumoral hypoxic subvolume during treatment (baseline: r=0.775, p<0.001; week 2: r=0.553, p=0.007; week 5: r=0.734, p<0.001). IL-6 levels in week 2 were higher in patients with absent early tumor hypoxia response (p=0.016) and predicted early hypoxia response (AUC=0.822, p=0.031). Increased IL-6 levels at week 5 resulted in a trend towards reduced progression-free survival (p=0.078) and overall survival (p=0.013).Plasma IL-6 is a promising surrogate marker for tumor hypoxia dynamics in HNSCC patients and may facilitate hypoxia-directed personalized radiotherapy concepts.The prospective trial was registered in the German Clinical Trial Register (DRKS00003830). Registered 20 August 2015.}, keywords = {Biomarker (Other) / FMISO-PET (Other) / Head-and-neck cancer (Other) / Hypoxia (Other) / Interleukin-6 (Other) / Radiotherapy (Other)}, cin = {E055 / FR01}, ddc = {610}, cid = {I:(DE-He78)E055-20160331 / I:(DE-He78)FR01-20160331}, pnm = {315 - Bildgebung und Radioonkologie (POF4-315)}, pid = {G:(DE-HGF)POF4-315}, typ = {PUB:(DE-HGF)16}, pubmed = {pmid:34773163}, doi = {10.1007/s00259-021-05602-x}, url = {https://inrepo02.dkfz.de/record/177407}, }