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Annals of Nuclear Medicine
Published in: Annals of Nuclear Medicine 1/2013

01-01-2013 | Original article

Predictive value of 3′-deoxy-3′-[18F]fluorothymidine positron emission tomography/computed tomography for outcome of carbon ion radiotherapy in patients with head and neck mucosal malignant melanoma

Authors: Masayuki Inubushi, Tsuneo Saga, Mitsuru Koizumi, Ryo Takagi, Azusa Hasegawa, Masashi Koto, Masaru Wakatuki, Takamichi Morikawa, Kyosan Yoshikawa, Katsuyuki Tanimoto, Toshimitsu Fukumura, Shigeru Yamada, Tadashi Kamada

Published in: Annals of Nuclear Medicine | Issue 1/2013

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Abstract

Objective

The purpose of this prospective study was to assess the prognostic value of 3′-deoxy-3′-[18F]fluorothymidine (FLT) positron emission tomography/computed tomography (PET/CT) for the outcome of carbon ion radiotherapy (CIRT) in patients with mucosal malignant melanoma (MMM) of the head and neck.

Methods

Thirteen patients (69 ± 13 years) with histologically proven MMM tumor were enrolled. CIRT was performed with a total dose of 57.6–64.0 gray equivalents per 16 fractions over a period of 4 weeks. FLT-PET/CT was performed before and again 1 month after CIRT. Tumor FLT uptake was quantitatively assessed using the maximum standardized uptake value (SUVmax). FLT-PET parameters [pre-CIRT SUVmax, post-CIRT SUVmax, and the reduction rate (RR)] and clinical parameters [age, gender, tumor site, tumor status, gross tumor volume (GTV), and regional lymph node involvement] were evaluated in relation to survival estimates. The follow-up period was 16.1 ± 5.9 months for 9 deceased patients, and 36.7 ± 7.9 months for 4 survivors.

Results

Pre-CIRT SUVmax of ≥4.3, age of ≥80 years old, sinonasal cavity tumor site, and GTV of ≥39 mL were found to be statistically significant prognostic factors for better overall survival. Pre-CIRT SUVmax of ≥5.0, age of ≥80 years old, sinonasal cavity tumor site, and the absence of regional lymph node involvement were statistically significant prognostic factors for better metastasis-free survival. RR of ≥35 % and GTV of <73 mL were predictive of better local control.

Conclusions

The present study indicated for the first time that in patients with the head and neck MMM, FLT-PET/CT imaging was useful for predicting the therapeutic outcome of CIRT. Our results will contribute to the establishment of an effective staging system for MMM based on prognostic factors, depending on treatment choice.
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Metadata
Title
Predictive value of 3′-deoxy-3′-[18F]fluorothymidine positron emission tomography/computed tomography for outcome of carbon ion radiotherapy in patients with head and neck mucosal malignant melanoma
Authors
Masayuki Inubushi
Tsuneo Saga
Mitsuru Koizumi
Ryo Takagi
Azusa Hasegawa
Masashi Koto
Masaru Wakatuki
Takamichi Morikawa
Kyosan Yoshikawa
Katsuyuki Tanimoto
Toshimitsu Fukumura
Shigeru Yamada
Tadashi Kamada
Publication date
01-01-2013
Publisher
Springer Japan
Published in
Annals of Nuclear Medicine / Issue 1/2013
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI
https://doi.org/10.1007/s12149-012-0652-x

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