title: Prediction of the response to docetaxel-based chemotherapy for locoregionally advanced nasopharyngeal carcinoma: the role of double-phase (99m)Tc-MIBI SPECT/CT.
abstract: To evaluate the role of double-phase (99m)Technetium labeled sestamibi ((99m)Tc-MIBI) single-photon emission computed tomography/compute tomography (SPECT/CT) in predicting the response to neoadjuvant chemotherapy with docetaxel-based regimen in patients with nasopharyngeal carcinoma. Thirty-nine pathologically proven nasopharyngeal carcinoma patients participated in this prospective study. Before treatment, early and delayed SPECT/CT images were obtained 5 min and 2 h after an intravenous injection of 25-30 mCi (99m)Tc-MIBI. All patients received neoadjuvant chemotherapy consisting of docetaxel, cisplatin plus 5-fluorouracil for two cycles. The relationships between the efficacy of neoadjuvant chemotherapy and early uptake ratio (EUR), delayed uptake ratio (DUR) and washout rate (WR) of (99m)Tc-MIBI were evaluated. The EUR of (99m)Tc-MIBI (2.8 ± 0.97) in the lesions which were sensitive to chemotherapy was significantly higher (p < 0.001) compared with that (1.69 ± 0.46) in the insensitive lesions. The difference of the DUR between the sensitive (1.65 ± 0.58) and the insensitive (1.06 ± 0.62) was also statistically significant (p = 0.011). However, the WR of (99m)Tc-MIBI was not significantly different between the two groups. When a EUR of 1.97 and a DUR of 1.06 were used as the cutoff value, the sensitivity, specificity, positive and negative predictive values were 76.1, 87.5, 97.2 and 38.8 % for EUR, 91.3, 67.5, 90 and 66.6 % for DUR, respectively. These results suggest that the early and delayed uptake ratios of (99m)Tc-MIBI calculated with SPECT/CT may have predictive value for identifying the response to neoadjuvant chemotherapy with docetaxel-based regimen in NPC patients.
authors.affiliation: Department of Radiation Oncology, Shanghai Cancer Center, Fudan University, 270 Dongan Road, Shanghai, 200032, People's Republic of China.
authors.forename: Chengrun
authors.initials: C
authors.lastname: Du
authors.forename: Hongmei
authors.initials: H
authors.lastname: Ying
authors.forename: Junjun
authors.initials: J
authors.lastname: Zhou
authors.forename: Jinjin
authors.initials: J
authors.lastname: Jiang
authors.forename: Chang
authors.initials: C
authors.lastname: Liu
authors.forename: Jingyi
authors.initials: J
authors.lastname: Chen
authors.forename: Xiaosheng
authors.initials: X
authors.lastname: Wang
authors.forename: Chaosu
authors.initials: C
authors.lastname: Hu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002277:Carcinoma; D002945:Cisplatin / Q000008:administration & dosage; D000077143:Docetaxel; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D043823:Taxoids / Q000008:administration & dosage; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D043823:Taxoids; D000077143:Docetaxel; D017256:Technetium Tc 99m Sestamibi; D002945:Cisplatin; D005472:Fluorouracil