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A Study on the Prognostic Evaluation of Carbon Ion Radiotherapy for Head and Neck Adenocarcinoma with C-11 Methionine PET

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Abstract

Purpose

Carbon ion radiotherapy (CIRT) has been developed, and a phase I/II CIRT trial has been conducted in patients with adenocarcinoma in the head and neck region. We evaluated whether the l-methyl [11C]-methionine (MET) uptake could be an early predictor for local recurrence, metastasis, and the prognosis in patients with adenocarcinoma in the head and neck region.

Methods

Twenty-six patients were prospectively studied by MET-positron emission tomography (PET) before and about 1 month after CIRT. The tumor MET uptake was measured with the semiquantitative tumor to normal tissue ratio (TNR). The tumor TNR and relevant clinical parameters were then evaluated by both univariate and multivariate analyses.

Results

The average TNRs before and after the treatment were 6.2 (±2.2) and 3.9 (±1.7), respectively, and significant differences were observed between them. In a univariate analysis, both local recurrence and metastasis were observed more frequently in the group with a higher TNR before and after the treatment than a lower TNR, and the prognosis was also poor. The cut-off values were 9.3, 4.9, and 5.1 before the treatment and 4.9, 4.2, and 4.3 after the treatment, respectively. In the rate of TNR changes before and after the treatment, metastasis was observed more frequently in the group with lower rates of change, and the prognosis was poor. The cut-off values for metastasis and prognosis determination were 18.0% and 16.9%, respectively. In a multivariate analysis, significant differences were observed for all relationships except for the relationship between the TNR before the treatment and local recurrence. Significant differences were observed for metastasis and prognosis in the rate of TNR changes before and after the treatment.

Conclusions

The determination of treatment effectiveness using TNR in CIRT for head and neck adenocarcinoma is an independent factor for predicting local recurrence, the incidence of metastasis, and the prognosis. MET-PET is therefore considered to be useful for determining the treatment effectiveness in patients with head and neck adenocarcinoma undergoing CIRT.

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Acknowledgments

Thanks are due to Kanichi Seto, Ph.D., and Yoshiki Hamada, Ph.D., at First Department of Oral and Maxillofacial Surgery, Tsurumi University School of Dental Medicine, for constant support and encouragement. We are indebted to attending staff, at First Department of Oral and Maxillofacial Surgery, Tsurumi University School of Dental Medicine, for constant support. We are also indebted to Hiroyuki Ishikawa, D.D.S., and Katsumi Tamura, Ph.D., and Kenji Sago, D.D.S., and staff of PET diagnosis section, at NIRS for constant support. This study was supported by the research project with heavy ions at the National Institute of Radiological Sciences-Heavy Ion Medical Accelerator in Chiba. Part of this study was presented at the 54th Annual Meeting of the Society of Nuclear Medicine in June 2007.

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  1. Mitsuhiko Hasebe

    Present address: Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, 4-9-1, Anagawa, Inage-ku, Chiba-shi, Chiba, Japan

Authors and Affiliations

  1. Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, 4-9-1, Anagawa, Inage-ku, Chiba-shi, Chiba, Japan

    Kyosan Yoshikawa, Seiya Ohashi, Sachiko Toubaru, Junetsu Mizoe & Hirohiko Tsujii

  2. First Department of Oral and Maxillofacial Surgery, Tsurumi University School of Dental Medicine, Yokohama, Japan

    Koji Kawaguchi & Junichi Sato

Authors
  1. Mitsuhiko Hasebe
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  2. Kyosan Yoshikawa
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  7. Junetsu Mizoe
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  8. Hirohiko Tsujii
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Correspondence to Kyosan Yoshikawa.

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Hasebe, M., Yoshikawa, K., Ohashi, S. et al. A Study on the Prognostic Evaluation of Carbon Ion Radiotherapy for Head and Neck Adenocarcinoma with C-11 Methionine PET. Mol Imaging Biol 12, 554–562 (2010). https://doi.org/10.1007/s11307-010-0318-9

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  • DOI: https://doi.org/10.1007/s11307-010-0318-9

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