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Title: EF5 binding and clinical outcome in human soft tissue sarcomas

Abstract

Purpose: To study the 2-nitroimidazole agent EF5 as a surrogate for measuring hypoxia in a series of patients with soft tissue sarcomas, and to determine whether hypoxia measured with this technique was associated with patient outcome. Methods and Materials: Patients with soft tissue sarcomas of the head and neck, extremity, trunk, or retroperitoneum for whom surgical excision was the initial treatment of choice, were given 21 mg/kg EF5 24-48 hours before surgery. Biopsy specimens were stained for EF5 binding with fluorescence-labeled monoclonal antibodies, and the images were analyzed quantitatively. Endpoints included the relationship between EF5 binding, clinically important prognostic factors, and patient outcome. Results: Two patients with recurrent and 14 patients with de novo sarcomas were studied. There were seven low-grade, one intermediate-grade, and eight high-grade tumors. No relationship was found between EF5 binding and patient age, sex, hemoglobin level, or tumor size. In de novo tumors, the presence of mitoses and histologic grade were positively correlated with hypoxia. High-grade and -stage de novo tumors had higher levels of EF5 binding compared with low-grade and -stage tumors. Patients with de novo tumors containing moderate to severe hypoxia ({>=}20% EF5 binding), high grade, or {>=}7% mitoses were more likely to developmore » metastases. Conclusions: Further studies in a larger cohort of patients are necessary to determine whether hypoxia, as measured by EF5 binding, is an independent prognostic factor for outcome in high-grade sarcomas. Such data should be useful to identify high-risk patients for clinical trials to determine whether early chemotherapy will influence the occurrence of metastasis.« less

Authors:
 [1];  [2];  [2];  [2];  [2];  [3]
  1. Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States). E-mail: sydevans@mail.med.upenn.edu
  2. Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States)|[Department of Surgery, University of Pennsylvania, Philadelphia, PA (United States)|[Department of Pathology, University of Pennsylvania, Philadelphia, PA (United States)|[Department of Biostatistics, University of Pennsylvania, Philadelphia, PA (United States)
  3. Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA (United States)|[Department of Surgery, University of Pennsylvania, Philadelphia, PA (United States)|[Department of Pathology, University of Pennsylvania, Philadelphia, PA (United States) [and others
Publication Date:
OSTI Identifier:
20793365
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 64; Journal Issue: 3; Other Information: DOI: 10.1016/j.ijrobp.2005.05.068; PII: S0360-3016(05)02823-3; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ANOXIA; BIOPSY; CHEMOTHERAPY; CLINICAL TRIALS; FLUORESCENCE; HEAD; HEMOGLOBIN; IMAGES; METASTASES; MONOCLONAL ANTIBODIES; NECK; PATIENTS; SARCOMAS; SURGERY

Citation Formats

Evans, Sydney M. V., Fraker, Douglas, Hahn, Stephen M., Gleason, Kristen, Jenkins, W. Timothy, and Jenkins, Kevin. EF5 binding and clinical outcome in human soft tissue sarcomas. United States: N. p., 2006. Web. doi:10.1016/J.IJROBP.2005.0.
Evans, Sydney M. V., Fraker, Douglas, Hahn, Stephen M., Gleason, Kristen, Jenkins, W. Timothy, & Jenkins, Kevin. EF5 binding and clinical outcome in human soft tissue sarcomas. United States. doi:10.1016/J.IJROBP.2005.0.
Evans, Sydney M. V., Fraker, Douglas, Hahn, Stephen M., Gleason, Kristen, Jenkins, W. Timothy, and Jenkins, Kevin. Wed . "EF5 binding and clinical outcome in human soft tissue sarcomas". United States. doi:10.1016/J.IJROBP.2005.0.
@article{osti_20793365,
title = {EF5 binding and clinical outcome in human soft tissue sarcomas},
author = {Evans, Sydney M. V. and Fraker, Douglas and Hahn, Stephen M. and Gleason, Kristen and Jenkins, W. Timothy and Jenkins, Kevin},
abstractNote = {Purpose: To study the 2-nitroimidazole agent EF5 as a surrogate for measuring hypoxia in a series of patients with soft tissue sarcomas, and to determine whether hypoxia measured with this technique was associated with patient outcome. Methods and Materials: Patients with soft tissue sarcomas of the head and neck, extremity, trunk, or retroperitoneum for whom surgical excision was the initial treatment of choice, were given 21 mg/kg EF5 24-48 hours before surgery. Biopsy specimens were stained for EF5 binding with fluorescence-labeled monoclonal antibodies, and the images were analyzed quantitatively. Endpoints included the relationship between EF5 binding, clinically important prognostic factors, and patient outcome. Results: Two patients with recurrent and 14 patients with de novo sarcomas were studied. There were seven low-grade, one intermediate-grade, and eight high-grade tumors. No relationship was found between EF5 binding and patient age, sex, hemoglobin level, or tumor size. In de novo tumors, the presence of mitoses and histologic grade were positively correlated with hypoxia. High-grade and -stage de novo tumors had higher levels of EF5 binding compared with low-grade and -stage tumors. Patients with de novo tumors containing moderate to severe hypoxia ({>=}20% EF5 binding), high grade, or {>=}7% mitoses were more likely to develop metastases. Conclusions: Further studies in a larger cohort of patients are necessary to determine whether hypoxia, as measured by EF5 binding, is an independent prognostic factor for outcome in high-grade sarcomas. Such data should be useful to identify high-risk patients for clinical trials to determine whether early chemotherapy will influence the occurrence of metastasis.},
doi = {10.1016/J.IJROBP.2005.0},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 3,
volume = 64,
place = {United States},
year = {Wed Mar 01 00:00:00 EST 2006},
month = {Wed Mar 01 00:00:00 EST 2006}
}