title: SUVmax of FDG-PET correlates with the effects of neoadjuvant chemoradiotherapy for oral squamous cell carcinoma.
abstract: The aim of this study was to analyze the relationship between the maximum standardized uptake value (SUVmax) of 18F-fluoro-2-deoxyglucose-positron emission tomography (FDG-PET) and the effects of neoadjuvant chemoradiotherapy in oral squamous cell carcinoma (OSCC), and to identify the possible biological background of this association. Thirty-seven patients with OSCC, who underwent preoperative FDG-PET followed by cancer treatment with neoadjuvant chemoradiotherapy, were enrolled in this study. The various histological effects following neoadjuvant chemoradiotherapy were compared to the SUVmax in the primary OSCC. These effects were also compared to the immunohistochemical staining score of hypoxia-inducible factor-1alpha (HIF-1alpha), glucose membrane transporter (GLUT)-1 and vascular endothelial growth factor (VEGF) in the biopsy specimen. Furthermore, we analyzed the chemosensitivity of KB-3-1 cells to cisplatin under hypoxic conditions using the MTT assay. A negative correlation was observed between the SUVmax and the histological effects following neoadjuvant chemoradiotherapy (p<0.01). The SUVmax was also correlated with the staining score of HIF-1alpha (p<0.03), but not with GLUT-1 and VEGF. The mean staining score of HIF-1alpha in the highly effective group was 2.7+/-1.1, which was significantly lower than that (3.7+/-0.9) of the poorly effective group (p<0.05). The cell chemosensitivity assay revealed chemoresistant effects under a hypoxic condition in OSCC. In conclusion, the SUVmax is correlated with the effectiveness of neoadjuvant chemoradiotherapy in OSCC. Our clinical and experimental analyses further suggest a possible association of the upregulation of HIF-1alpha with chemoradiosensitivity in SCC cells.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8520, Japan. makihiko@denta.hal.kagoshima-u.ac.jp
authors.forename: Akihiko
authors.initials: A
authors.lastname: Miyawaki
authors.forename: Ryuji
authors.initials: R
authors.lastname: Ikeda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hijioka
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ishida
authors.forename: Mina
authors.initials: M
authors.lastname: Ushiyama
authors.forename: Etsuro
authors.initials: E
authors.lastname: Nozoe
authors.forename: Norifumi
authors.initials: N
authors.lastname: Nakamura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000737:chemistry / Q000000981:diagnostic imaging* / Q000628:therapy*; D015687:Cell Hypoxia; D045744:Cell Line, Tumor; D002470:Cell Survival / Q000187:drug effects; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000494:pharmacology; D019583:Dose Fractionation, Radiation; D004305:Dose-Response Relationship, Drug; D019008:Drug Resistance, Neoplasm; D005260:Female; D019788:Fluorodeoxyglucose F18; D051272:Glucose Transporter Type 1 / Q000032:analysis; D006801:Humans; D051795:Hypoxia-Inducible Factor 1, alpha Subunit / Q000032:analysis; D007150:Immunohistochemistry; D020128:Inhibitory Concentration 50; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000737:chemistry / Q000000981:diagnostic imaging* / Q000628:therapy*; D020360:Neoadjuvant Therapy; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011300:Preoperative Care; D019275:Radiopharmaceuticals; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis
chemical_list: D051272:Glucose Transporter Type 1; C497442:HIF1A protein, human; D051795:Hypoxia-Inducible Factor 1, alpha Subunit; D019275:Radiopharmaceuticals; C495677:SLC2A1 protein, human; D042461:Vascular Endothelial Growth Factor A; D019788:Fluorodeoxyglucose F18; D002945:Cisplatin