Comparison of Physical Examination and Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography 4–6 Months After Radiotherapy to Assess Residual Head-and-Neck Cancer
| Autor: | Dian Wang, Bruce H. Campbell, M. Tracy Zundel, Michelle A. Michel, Christopher J. Schultz, Joel H. Blumin, Mohit Maheshwari, Stuart J. Wong, Becky L. Massey, J. Frank Wilson |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Neoplasm Residual medicine.medical_treatment Standardized uptake value Multimodal Imaging Sensitivity and Specificity Young Adult Fluorodeoxyglucose F18 medicine Humans Radiology Nuclear Medicine and imaging Treatment Failure Physical Examination Aged Retrospective Studies Aged 80 and over Fluorodeoxyglucose PET-CT Radiation medicine.diagnostic_test business.industry Neck dissection Chemoradiotherapy Middle Aged Radiation therapy Oncology Head and Neck Neoplasms Positron emission tomography Positron-Emission Tomography Female Radiology Radiopharmaceuticals Tomography X-Ray Computed Nuclear medicine business Emission computed tomography Follow-Up Studies medicine.drug |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 81:e825-e832 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2010.11.072 |
| Popis: | Purpose To retrospectively compare fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) and physical examination 4–6 months after radiotherapy for assessing residual head-and-neck cancer (HNC). Methods and Materials From July 2002 through March 2006, 52 HNC patients underwent definitive radiotherapy or chemoradiotherapy. Categoric assessments of residual tumor by PET/CT and physical examination 4–6 months after therapy were correlated and compared with clinical outcomes. Pretreatment data, including tumor stage and primary site standardized uptake value, were also gathered retrospectively and correlated with clinical outcomes. Median follow-up time was 58 months. Results Twenty-one patients had either locoregionally "positive" (17 of 21) or "equivocal" (4 of 21) PET/CT scans, whereas 31 patients had locoregionally negative scans. Four patients failed treatment and had biopsy-confirmed residual or recurrent local disease. All patients, including patients with locally suspicious scans or examinations who refused biopsies, were followed clinically for a minimum of 29 months after therapy, with no other cases of treatment failure detected during this time. No patient had residual nodal disease after therapy. Sensitivities of PET/CT vs. physical examination for early detection of treatment failure were 100% vs. 50%, whereas the specificities of the two modalities were 64.6% vs. 89.6%, respectively. Higher initial T stage and American Joint Commission on Cancer stage correlated with increased incidence of positive/equivocal PET/CT results and treatment failure. Maximal standardized uptake value was not predictive of any clinical outcome. Conclusions A negative result on PET/CT obtained 4–6 months after radiotherapy is highly sensitive and correlates with successful locoregional control. Patients with negative scans may reasonably be spared invasive diagnostic procedures, such as biopsy and neck dissection, unless recurrent disease is suspected on clinical grounds. Close follow-up is prudent for HNC patients with abnormal findings on posttherapy PET/CT scan. |
| Databáze: | OpenAIRE |
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