A prospective observational study of Gallium-68 ventilation and perfusion PET-CT during and after radiotherapy in patients with non-small cell lung cancerReportar como inadecuado




A prospective observational study of Gallium-68 ventilation and perfusion PET-CT during and after radiotherapy in patients with non-small cell lung cancer - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

BMC Cancer

, 14:740

Clinical oncology

Abstract

BackgroundNon-small cell lung cancer NSCLC accounts for 85% of lung cancers, and is the leading cause of cancer deaths. Radiation therapy RT, alone or in combination with chemotherapy, is the standard of care for curative intent treatment of patients with locally advanced or inoperable NSCLC. The ability to intensify treatment to achieve a better chance for cure is limited by the risk of injury to the surrounding lung.

Methods-DesignThis is a prospective observational study of 60 patients with NSCLC receiving curative intent RT. Independent human ethics board approval was received from the Peter MacCallum Cancer Centre ethics committee. In this research, Galligas and Gallium-68 macroaggregated albumin MAA positron emission tomography PET imaging will be used to measure ventilation V and perfusion Q in the lungs. This is combined with computed tomography CT and both performed with a four dimensional 4D technique that tracks respiratory motion. This state-of-the-art scan has superior resolution, accuracy and quantitative ability than previous techniques. The primary objective of this research is to observe changes in ventilation and perfusion secondary to RT as measured by 4D V-Q PET-CT. Additionally, we plan to model personalised RT plans based on an individual’s lung capacity. Increasing radiation delivery through areas of poorly functioning lung may enable delivery of larger, more effective doses to tumours without increasing toxicity. By performing a second 4D V-Q PET-CT scan during treatment, we plan to simulate biologically adapted RT depending on the individual’s accumulated radiation injury. Tertiary aims of the study are assess the prognostic significance of a novel combination of clinical, imaging and serum biomarkers in predicting for the risk of lung toxicity. These biomarkers include spirometry, 18 F-Fluorodeoxyglucose PET-CT, gamma-H2AX signals in hair and lymphocytes, as well as assessment of blood cytokines.

DiscussionBy correlating these biomarkers to toxicity outcomes, we aim to identify those patients early who will not tolerate RT intensification during treatment. This research is an essential step leading towards the design of future biologically adapted radiotherapy strategies to mitigate the risk of lung injury during dose escalation for patients with locally advanced lung cancer.

Trials registrationUniversal Trial Number UTN U1111-1138-4421.

KeywordsPositron emission tomography Definitive radiation Lung cancer 4D Adaptive radiotherapy Biological dose escalation Biomarkers Gamma-H2AX Inflammatory cytokines Electronic supplementary materialThe online version of this article doi:10.1186-1471-2407-14-740 contains supplementary material, which is available to authorized users.

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Autor: Shankar Siva - Jason Callahan - Tomas Kron - Olga A Martin - Michael P MacManus - David L Ball - Rodney J Hicks - Micha

Fuente: https://link.springer.com/







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