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IP01: Head and Neck

Evaluation of hypoxic bio-imaging with PET in head and neck cancer patients

Objectives
To evaluate if hypoxic PET tracers (18F-FAZA or 64Cu-ATSM PET) can detect qualitatively and quantitatively radiobiological hypoxia in HN tumours using pimonidazole as a reference. To evaluate the prognostic value of hypoxic PET bioimaging in HN cancer after radiotherapy.
Study outline (intervention) The study will involve 3 sub protocols. a) evaluation of hypoxic PET tracer. 20 patients will preoperatively be scanned prior to surgery and simultaneous given the hypoxic tracer pimonidazole which can be detected by immunohistochemistry. Comparative evaluation of PET tracer (by autoradiography) and pimonidazole in the surgical specimen will be used for evaluation of the spatial localization of the PET tracer, and correlated with genetic markers for individual (hypoxic) sensitivity. b) The prognostic value of hypoxia detected by PET will be evaluated in 40 patients with HN cancer treated with radiotherapy according to DAHANCA guidelines. Based on previous invasive hypoxic measurements will this pts number be sufficient to evaluate the potential prognostic value of the PET procedure. c) a subset of patients (approx. 20) of those included in subprotocol b will during radiotherapy be given multiple PET scans (1-2 weeks interval) to evaluate the time influence on the hypoxic volume. Furthermore the data from these patients will be used for evaluation of the biological dosimetry and dose painting.
Expected impact Definition of hypoxia as a bio-imaging agent which will be used (as a model) for clinical evaluation of biological dosimetry and dose planning. 4-D characterisation of hypoxia in head and neck cancers. Evaluation of the prognostic/predictive importance of radiobiological hypoxia as a cause of radioresistance. Create the basis for biological based treatment planning.
Linkages with work packages WP 1, 2, 4, 6.

PhD student Lise Saksø Mortensen project synopsis

Protocols:

CIRRO-IP010109 - Bestemmelse af tumor hypoksi med 18F -FAZA Positron Emissions Tomografi i tumorer hos patienter med operabel hoved-hals karcinom (DAHANCA 23)

CIRRO-IP010209 - Den prognostiske værdi af 18F -FAZA Positron Emissions Tomografi hos patienter med hoved-hals karcinom efter primær strålebehandling (DAHANCA 24)

CIRRO-IP010309 - Styrketræning kombineret med kosttilskud som intervention til genopbygning af muskelmasse efter strålebehandling for hoved‐hals cancer (DAHANCA 25A)