Positron Emission Tomography With [18F]Fluorodeoxyglucose Improves Staging and Patient Management in Patients With Head and Neck Squamous Cell Carcinoma: A Multicenter Prospective Study
| Autor: | Michel Toubeau, Gilles Calais, Max Lonneux, Marc Hamoir, Laurence Digue, B. Bridji, Philippe Maingon, Vincent Grégoire, Hervé Reychler, Christian Duvillard |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male Cancer Research Fluorodeoxyglucose F18 medicine Carcinoma Humans Prospective Studies Stage (cooking) Prospective cohort study neoplasms Aged Neoplasm Staging Fluorodeoxyglucose medicine.diagnostic_test business.industry Head and neck cancer Magnetic resonance imaging Middle Aged medicine.disease Head and neck squamous-cell carcinoma Oncology Head and Neck Neoplasms Positron emission tomography Positron-Emission Tomography Carcinoma Squamous Cell Female Radiopharmaceuticals business Nuclear medicine medicine.drug |
| Zdroj: | Journal of Clinical Oncology. 28:1190-1195 |
| ISSN: | 1527-7755 0732-183X |
| DOI: | 10.1200/jco.2009.24.6298 |
| Popis: | Purpose To address the impact of positron emission tomography with [18F]fluorodeoxyglucose (PET-FDG) on the initial staging and management of patients with head and neck squamous cell carcinoma (HNSCC). Patients and Methods This multicenter, prospective study included 233 patients with newly diagnosed and untreated HNSCC. TNM stage and therapeutic decision were first determined based on the conventional work-up (including physical examination, computed tomography [CT]/magnetic resonance imaging of the head and neck region, and thoracic CT) and sealed in envelope 1. Whole-body PET-FDG was then performed, and subsequent TNM stage and therapeutic decision were written in envelope 2. Changes in TNM stages and in patient management as a result of PET-FDG imaging were recorded. Clinical outcome and histopathology were used as gold standards to validate the TNM stage. Conventional and PET stages were compared using the McNemar test. Results Conventional and PET stage were discordant in 100 (43%) of 233 patients. PET proved to be accurate in 47 patients and inaccurate in 13 patients. TNM status was left unconfirmed in 40 patients because no therapeutic change was expected from the stage difference. Conventional + PET TNM classification (envelope 2) was significantly more accurate than conventional classification (envelope 1; P < .0001, McNemar test). PET-FDG altered the therapeutic plan in 32 (13.7%) of 233 patients. Conclusion Adding whole-body PET-FDG to the pretherapeutic conventional staging of HNSCC improved the TNM classification of the disease and altered the management of 13.7% of patients. These findings support the implementation of PET-FDG in the routine imaging work-up of HNSCC. |
| Databáze: | OpenAIRE |
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