Surveillance for Recurrent Head and Neck Cancer Using Positron Emission Tomography

Lowe, Val J.; Boyd, James H.; Dunphy, Frank; Kim, Han; Dunleavy, Teresa L.; Collins, Brian T.; Martin, David S.; Stack, Brendan C.; Hollenbeak, C.; Fletcher, James

doi:10.1200/jco.2000.18.3.651

Cited by 220 publications

(106 citation statements)

References 12 publications

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“…The results of several prior studies using sequential PET in the follow-up of HNSCC support our findings [6,19,21,22,24]. In a retrospective study of 156 patients treated for HNSCC, the sensitivity and NPV of PET/CT for recurrence were 92.5% and 95%, compared with 55% and 77% for conventional evaluation methods.…”

Section: Discussionsupporting

confidence: 87%

Early Detection of Recurrent Disease by FDG-PET/CT Leads to Management Changes in Patients With Squamous Cell Cancer of the Head and Neck

Kostakoğlu¹,

Fardanesh²,

Posner

et al. 2013

The Oncologist

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Objective. The objective of this study was to compare the efficacy of surveillance high-resolution computed tomography (HRCT) and physical examination/endoscopy (PE/E) with the efficacy of fluorodeoxyglucose (FDG)-positron emission tomography (PET)/HRCT for the detection of relapse in head and neck squamous cell carcinoma (HNSCC) after primary treatment. Methods. This is a retrospective analysis of contemporaneously performed FDG-PET/HRCT, neck HRCT, and PE/E in 99 curatively treated patients with HNSCC during post-therapy surveillance to compare performance test characteristics in the detection of early recurrence or second primary cancer. Results. Relapse occurred in 19 of 99 patients (20%) during a median follow-up of 21 months (range: 9 -52 months). Median time to first PET/HRCT was 3.5 months. The median time to radiological recurrence was 6 months (range: 2.3-32 months). FDG-PET/ HRCT detected more disease recurrences or second primary cancers and did so earlier than HRCT or PE/E. The sensitivity, specificity,andpositiveandnegativepredictivevaluesfordetectinglocoregionalanddistantrecurrenceorsecondprimarycancer were 100%, 87.3%, 56.5%, and 100%, respectively, for PET/HRCT versus 61.5%, 94.9%, 66.7%, and 93.8%, respectively, for HRCT versus 23.1%, 98.7%, 75%, and 88.6%, respectively, for PE/E. In 19 patients with true positive PET/HRCT findings, a significant change in the management of disease occurred, prompting either salvage or systemic therapy. Of the 14 curatively treated patients, 11 were alive with without disease at a median follow-up of 31.5 months. Conclusion. FDG-PET/HRCT has a high sensitivity in the early detection of relapse or second primary cancer in patients with HNSCC, with significant management implications. Given improvements in therapy and changes in HNSCC biology, appropriate modifications in current post-therapy surveillance may be required to determine effective salvage or definitive therapies. The Oncologist 2013;18:1108 -1117 Implications for Practice: The role of PET/CT in the post-therapy surveillance of head and neck cancer is not defined by prospective studies, but cumulative retrospective data support the use of FDG-PET/CT in this setting. By corroborating prior results, we believe that we have an important message for physicians and health insurance carriers, that after completion of primary definitive treatment, surveillance PET/CT detects relapse earlier than both diagnostic CT and NCCN-recommended conventional methods. Although retrospectively, we report a significant change in disease management after PET/CT results suggested a survival benefit compared with reported historical data. We found that most patients had recurrence in the first 2 years after completion of therapy, and PET/CT detected most recurrences within the first 6-month period. Our findings corroborate those of other authors, and therefore, there is merit to recommending a post-therapy scan 3-4 months after completion of therapy, followed by another scan within the first year and scanning every 6 months ...

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Section: Discussionsupporting

confidence: 87%

Early Detection of Recurrent Disease by FDG-PET/CT Leads to Management Changes in Patients With Squamous Cell Cancer of the Head and Neck

Kostakoğlu¹,

Fardanesh²,

Posner

et al. 2013

The Oncologist

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“…In small series, PET/CT seems to offer advantages in the detection of recurrent or persistent disease, with specificity and sensitivity close to 100%, as compared with 75% for CT or MRI (11,12) . In the present study, PET/CT was utilized for assessment of response to radiotherapy (either in association or not with chemotherapy) in 22 cases (35%).…”

Section: Discussionmentioning

confidence: 99%

“…In all such conditions changes in the approach may potentially occur (10) . In some series, the second tumor incidence ranged between 11.1% and 12.9% (11,12) , while lymph node disease presented specificity of 87% to 100% and sensitivity between 47% and 100% (13) . As from October 2009, the Department of Head and Neck Surgery and Otorhynolaryngology of Hospital Heliópolis started utilizing PET/CT for selected cases (either for initial staging, evaluation of post-treatment response, or investigation for recurrences or distant metastasis), whose usual evaluation methods were not safe with respect to prognosis of the neoplasms.…”

Section: Introductionmentioning

confidence: 99%

Valor da PET/CT na abordagem do câncer de cabeça e pescoço

Curioni

Souza²,

Amar

et al. 2012

Radiol Bras

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Objective: To evaluate the role of PET/CT in the approach to patients with head and neck cancer. Materials and Methods: Retrospective study of medical records and PET/CT images of 63 patients with head and neck cancer. Results: Alterations were observed in 76% of the cases. Out of these cases, 7 (11%) were considered as false-positive, with SUV < 5.0. PET/CT demonstrated negative results in 15 cases (24%). Among the 14 cases where the method was utilized for staging, 3 (22%) had their stages changed. Conclusion: PET/CT has shown to be of potential value in the routine evaluation of patients with head and neck cancer, but further studies of a higher number of cases are required to define a protocol for utilization of the method. Keywords: Emission computed tomography; Fluorodeoxyglucose 18F; Head and neck neoplasms; Neoplasm staging; Squamous cell carcinoma.Objetivo: Avaliar a PET/CT na abordagem de pacientes com câncer de cabeça e pescoço. Materiais e Métodos: Estudo retrospectivo de 63 prontuários e exames de PET/CT de pacientes com câncer de cabeça e pescoço. Resultados: Foram encontradas alterações em 76% dos exames. Destes, 7 (11%) foram considerados falso-positivos, com SUV < 5,0. A PET/CT mostrou-se negativa em 15 situações (24%). Dos 14 casos nos quais se utilizou o exame para estadiamento, em 3 (22%) houve aumento no estadiamento. Conclusão: A PET/CT mostra-se como exame de potencial valor na rotina de avaliação de pacientes com câncer de cabeça e pescoço, entretanto, necessitamos de maior número de casos para definirmos protocolo de uso. Unitermos: Tomografia computadorizada de emissão; Fluordesoxiglicose F18; Neoplasias de cabeça e pescoço; Estadiamento de neoplasias; Carcinoma de células escamosas. AbstractResumo * Study developed in the

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“…Therefore, the specificity and false-positive rates should be considered critically in comparison with other studies that report only a single scan in a treated patient. 10,11,[24][25][26][27][28][29][30][31][32][33] In a recent meta-analysis of studies investigating the effectiveness of a single PET scan after RT that included patients with suspected disease recurrence, the sensitivity, specificity, positive predictive value, and negative predictive value were 94%, 82%, 75%, and 95%, respectively. 25 In our experience, false-positive findings in the head and neck remain an issue for PET or PET/CT in the followup care of patients with head and neck cancer.…”

Section: Discussionmentioning

confidence: 99%

The diagnostic and prognostic utility of positron emission tomography/computed tomography‐based follow‐up after radiotherapy for head and neck cancer

Kao

Genden

et al. 2009

Cancer

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Nitroxyl radicals were used as functionalizing agents during the free radical postreactor modification process of polyolefins carried out in the melt. The 4‐hydroxy‐2,2,6,6‐tetramethylpiperidine‐1‐oxyl (HO‐TEMPO) and the 4‐benzoyloxy‐2,2,6,6‐tetramethylpiperidine‐1‐oxyl (BzO‐TEMPO) free radicals were successfully grafted onto a polyethylene‐based material (ethylene‐co‐1‐octene copolymer) by coupling reaction with polymer macroradicals; these last were formed by H‐abstraction through peroxide addition. The macromolecular structure of the functionalized polyolefins was assessed by 1H‐NMR, FTIR spectroscopy, and SEC measurements which were used to evidence the grafting site, to evaluate the grafting level and to highlight the occurrence of chain extension through crosslinking side reactions. Indeed the use of proper model compounds allowed the preparation of accurate FTIR calibration curves for the quantitative determination of the functionalization degree. Besides the high temperature SEC analysis highlighted that this fast and simple coupling reaction between macroradicals and nitroxyl free radicals grants the grafting of functionalities onto the polyolefin backbone by contemporarily preventing the side reactions liable of the structure and MW modification of the pristine polymer. © 2010 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem, 2011

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Surveillance for Recurrent Head and Neck Cancer Using Positron Emission Tomography

Abstract: PET can detect head and neck tumor recurrence when it may be undetectable by other clinical methods. FDG-PET permits highly accurate detection of head and neck cancer recurrence in the posttherapy period.

Cited by 220 publications

References 12 publications

Early Detection of Recurrent Disease by FDG-PET/CT Leads to Management Changes in Patients With Squamous Cell Cancer of the Head and Neck

Early Detection of Recurrent Disease by FDG-PET/CT Leads to Management Changes in Patients With Squamous Cell Cancer of the Head and Neck

Valor da PET/CT na abordagem do câncer de cabeça e pescoço

The diagnostic and prognostic utility of positron emission tomography/computed tomography‐based follow‐up after radiotherapy for head and neck cancer

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