New strategy based on PET diagnosis for organ preservation in oral squamous cell carcinoma
| Project/Area Number |
17390527
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Surgical dentistry
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| Research Institution | HOKKAIDO UNIVERSITY |
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Principal Investigator |
KITAGAWA Yoshimasa Hokkaido Univ., Grad. School of Dental Medicine, Professor, 大学院歯学研究科, 教授 (00224957)
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| Co-Investigator(Kenkyū-buntansha) |
TAMAKI Nagara Hokkaido Univ., Grad. School of Medicine, Professor, 大学院歯学研究科, 教授 (30171888)
YAMAZAKI Yutaka Hokkaido Univ., Hokkaido University Hospital, Lecturer, 北海道大学病院, 講師 (90250464)
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| Project Period (FY) |
2005 – 2006
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| Project Status |
Completed (Fiscal Year 2006)
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| Budget Amount *help |
¥15,600,000 (Direct Cost: ¥15,600,000)
Fiscal Year 2006: ¥5,600,000 (Direct Cost: ¥5,600,000)
Fiscal Year 2005: ¥10,000,000 (Direct Cost: ¥10,000,000)
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| Keywords | Functional Imaging / Oral Cancer / MET-PET / Methionine / FDG-PET / Glucose Metabolism / SUV / Response to Therapy / 口腔がん / 治療判定効果 / リンパ節転移 / 頭頸部癌 / 予後予測 |
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| Research Abstract |
Recently, neoadiuvant chemoradiotherapy as an organ-preserving protocol has shown good clinical response in patients with oral cancer. To reduce functional damage caused by surgery, accurate evaluation of therapeutic effect is essential to determine further operation after the chemoradiotherapy in consideration of the patient l s prognosis and quality of life. We have previously shown the clinical value of FDG-PET for monitoring response to combined intraarterial chemotherapy with radiotherapy. The aim of this study was to evaluate the possible usefulness of positron emission tomography with 18F labeled fluorodeoxyglucose (FDG-PET) for predicting response to intraarterial chemoradiotherapy and prognosis in oral carcinomas. We also evaluate the diagnostic significance of FDG-PET when we determine whether to perform reduced form of surgery after chemoradiotherapy. Thirty-five patients with oral squamous cell carcinoma (SCC) were included in the study. All patients completed the treatment
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regimen of intraarterial chemoradiotherapy (THP-ADM + 5-FU + carboplatin), and each patient underwent 2 FDG-PET studies, one prior to and one at 4 weeks after the chemoradiotherapy. The pre-and post-treatment PET images were compared with clinical and histopathological evaluations of the treatment effect. For the quantitative evaluation of regional radioactivity, standardized uptake values (SUVs) were used. The chemoradiotherapy demonstrated good clinical response (Overall clinical response rate 100%; CR rate 71%) and histological response (p-CR rate 83%). All neoplastic lesions showed high SUVs (mean, 10.00 mg/ml) prior to the treatment, which values significantly decreased after the therapy (3.74 mg/ml, p<0.01). Change in FDG uptake paralleled the treatment effect. Lesions with higher pre-SUVs (>7 mg/mL) showed residual viable tumor cells after the treatment in 6 out of 25 patients, and 3-year survival rate of 80%. whereas those with lower SUVs (<7 mg/mL, 10 patients) were successfully treated, and showed higher 3-year survival (90%). Six out of 13 tumors with post-SUVs >4 mg/ml had viable tumor cells, whereas all (22/22) tumors with post-SUVs <4 mg/mL showed no viable cells. Based on PET results, 10 patients avoided operation altogether, and 19 patients underwent a reduced form of surgery. Each patient showed no local recurrence within 5-year follow-up. Tumors with low pre-SUV (<7mg/mL) are expected to disappear with our intraarterial chemoradiotherapy. Tumors with more resistance to the treatment (pre-SUV>7mg/mL and post-SUV>4 mg/mL) need extended surgery and/or adjuvant therapy. Pretreatment FDG-PET is useful in predicting the response to treatment and prognosis. Posttreatment FDG-PET can evaluate residual viable cells and prognosis. Organ preservation may be feasible based on PET evaluation. Hence FDG-PET is a valuable tool in the treatment of oral cancer. Less
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Report
(3 results)
Research Products
(8 results)
