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18F-FLT PET changes during radiotherapy combined with cetuximab in head and neck squamous cell carcinoma patients
B A W Hoeben1, E G C Troost, J Bussink
1Bianca A.W. Hoeben, MD Radboud University Medical Center, Department of Radiation Oncology 874, P. O. Box 9101, 6500 HB Nijmegen, The Netherlands, Tel. +31/24/361 45 15; Fax +31/24/361 07 92,
Aim:
Early treatment response of head and neck cancer to radiotherapy concomitant with cetuximab was monitored by repetitive PET imaging with the proliferation tracer 18F-FLT.
Patients, Methods:
Five head and neck cancer patients, treated with radiotherapy and concomitant cetuximab following cetuximab induction, received four 18F-FLT PET-CT scans before and during treatment. Changes in SUVpeak, SUVmean and CT- and PET-segmented gross tumour volumes were evaluated, as were correlations with immunohistochemical staining for Epidermal Growth Factor Receptor (EGFR) and Ki-67 (proliferation marker) in pre-treatment tumour biopsies.
Results:
18F-FLT PET measured tumor responses to the induction dose of cetuximab varied from 43% SUVpeak decrease to 47% increase. After start of radiotherapy 18F-FLT PET parameters decreased significantly in all patients. No associations were found between PET parameters and EGFR or Ki-67 expression levels.
Conclusion:
Proliferation of head and neck carcinomas shows a varying response to cetuximab induction, but consistently decreases after addition of radiotherapy.
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