Clinical Prognosis And Evaluation Of Radiosensitization Effect Of Glycididazole Sodium On Nasopharyngeal Carcinoma By ¹⁸F-FDG And ¹⁸F-FMISO PET/CT Imaging

Objective1.To investigate the changes of hypoxia status in nasopharyngeal tumors before and after radiosensitization therapy via ¹⁸F-FDG and ¹⁸F-FMISO PET/CT.2.¹⁸F-FMISO and MRI imaging,blood CEA and Hsp90?were measured in patients after radiosensitization with glycididazole sodium.The efficacy and prognosis of patients treated with glycididazole sodium were evaluated.Methods1.Forty patients with nasopharyngeal carcinoma who had been diagnosed by pathology as local recurrence after endoscopic radical radiotherapy were randomly divided into control group?radiotherapy alone?and experimental group?sodium glycididazole combined with radiotherapy?.All patients were imaged by ¹⁸F-FDG and¹⁸F-FMISO PET/CT before and after therapy.¹⁸F-FMISO PET/CT was scanned the next day after ¹⁸F-FDG PET/CT.The maximum standardized uptake value?SUVmax?of tumor and muscle,tumor muscle ratio?TMR?and hypoxic volume?HV?were determined and calculated for hypoxia status and radiosensitization effect evaluation.2.¹⁸F-FMISO PET/CT examination was performed after the first part of the study,after the end of radiotherapy.The tumor TMR value and blood CEA and Hsp90?values were measured,and the local control rate of the two groups of patients was compared to determine the efficacy of radiosensitization.Results1.The TMR value?2.46±0.78?of ¹⁸F-FDG uptake of tumors in the experimental group after therapy was slightly lower than that in the control group?2.69±0.68?,however there was no significantly difference between two groups?t=1.81,P>0.05?.¹⁸F-FMISO,the TMR of the test group,after the radiotherapy,is lower than the control TMR,and the difference has a statistical significance?t=3.747,P<0.01?.The reduction of tumor hypoxia volume in the experimental group after therapy?1.72±0.59?was greater than that in the control group?1.26±0.56?,the difference was statistically significant?t=26,P<0.05?.2.The TMR value of the ¹⁸F-FMISO imaging was?1.60±0.28?in the 3 months after radiotherapy,which was lower than the TMR value of the control group?2.09±0.52?,and the difference was statistically significant?t=3.365,P<0.05?.After radiotherapy 3the monthly blood CEA value?2.09±0.97?was lower than the control group CEA value?2.89±0.88?,and the difference was statistically significant?t=3.365,P<0.05?.The blood Hsp90?value?89.72±23.19?in the 3 months after radiotherapy was higher than that in the control group?85.19±22.45?,and the difference was not statistically significant?t=0.561,P>0.05?.Conclusion1.¹⁸F-FDG and ¹⁸F-FMISO PET/CT were idea tools for radiosensitization response evaluation.Compared with ¹⁸F-FDG,¹⁸F-FMISO provide more information on the changes in tumor hypoxia status.1.The local control rate of glycidazole sodium radiosensitization is better than that of radiotherapy alone.Therefore,the use of sodium glycidazole sodium sensitization can improve the prognosis of patients with nasopharyngeal carcinoma.