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Clinical and Statistical Considerations when Assessing Oxygen Levels in Tumors: Illustrative Results from Clinical EPR Oximetry Studies

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Oxygen Transport to Tissue XLI

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 1232))

Abstract

The success of treatment for malignancies, especially those undergoing radiation therapy or chemotherapy, has long been recognized to depend on the degree of hypoxia in the tumor. In addition to the prognostic value of knowing the tumor’s initial level of hypoxia, assessing the tumor oxygenation during standard therapy or oxygen-related treatments (such as breathing oxygen-enriched gas mixtures or taking drugs that can increase oxygen supply to tissues) can provide valuable data to improve the efficacy of treatments. A series of early clinical studies of tumors in humans are ongoing at Dartmouth and Emory using electron paramagnetic resonance (EPR) oximetry to assess tumor oxygenation, initially and over time during either natural disease progression or treatment. This approach has the potential for reaching the long-sought goal of enhancing the effectiveness of cancer therapy. In order to effectively reach this goal, we consider the validity of the practical and statistical assumptions when interpreting the measurements made in vivo for patients undergoing treatment for cancer.

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Acknowledgments

Major funding is from the National Cancer Institute, PPG Grant P01CA190193 and Dept Neurol, Alexander Reeves Endowment Pilot Project 1 (CIPN). We gratefully acknowledge BW Pogue (Co- Principal investigator of the PPG), P Kuppusamy (PI of PPG’s Project 2: Oximetry using the OxyChip), E Demidenko (Director of PPG’s Biostatistics Core) and the study clinical coordinators (VA Wood and KA Hebert at Dartmouth and JJ Jeong and S Henry at Emory), as well as the engineers and clinicians who contributed to these studies at all participating institutions. All data reported here were gathered under IRB protocols at the respective institutions and all volunteers signed written informed consent. Disclaimer: ABF and HMS are owners of Clin-EPR, LLC which manufacturers clinical EPR instruments for investigational use only.

Author information

Authors and Affiliations

  1. Department Radiology, Dartmouth Medical School, Hanover, NH, USA

    A. B. Flood, B. B. Williams, W. Schreiber & H. M. Swartz

  2. Department Radiation Oncology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA

    P. E. Schaner, B. B. Williams & H. M. Swartz

  3. Department Radiation Oncology, University Medical Center, Mainz, Germany

    P. Vaupel

  4. Louvain Drug Research Institute, Université catholique de Louvain, Brussels, BE, Belgium

    B. Gallez

  5. Department Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA

    E. Y. Chen

  6. Department Radiation Oncology, Emory School of Medicine, Atlanta, GA, USA

    A. Ali & T. Liu

  7. Department Neurology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA

    V. H. Lawson

Authors
  1. A. B. Flood
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  2. P. E. Schaner
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  6. E. Y. Chen
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  7. A. Ali
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  8. T. Liu
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  9. V. H. Lawson
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  10. W. Schreiber
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  11. H. M. Swartz
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Corresponding author

Correspondence to A. B. Flood .

Editor information

Editors and Affiliations

  1. Department of Veterinary Pharmacology, College of Veterinary Medicine, Seoul National University, Seoul, Korea (Republic of)

    Pan-Dong Ryu

  2. Department of Physiology and Biophysics, School of Medicine, Case Western Reserve University, Cleveland, OH, USA

    Joseph C. LaManna

  3. Heilig-Kreuz-Strasse 19, St. Lorenzen, Italy

    David K. Harrison

  4. Department of Oriental Biomedical Engineering, Sangji University, Wonju, Korea (Republic of)

    Sang-Suk Lee

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Flood, A.B. et al. (2020). Clinical and Statistical Considerations when Assessing Oxygen Levels in Tumors: Illustrative Results from Clinical EPR Oximetry Studies. In: Ryu, PD., LaManna, J., Harrison, D., Lee, SS. (eds) Oxygen Transport to Tissue XLI. Advances in Experimental Medicine and Biology, vol 1232. Springer, Cham. https://doi.org/10.1007/978-3-030-34461-0_20

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