Systematic review: Accuracy of imaging tests in the diagnosis of recurrent laryngeal carcinoma after radiotherapy

Brouwer, Jolijn; Hooft, Lotty; Hoekstra, Otto S.; Riphagen, Ingrid I.; Castelijns, Jonas A.; Bree, Remco de; Leemans, C. René

doi:10.1002/hed.20790

Cited by 43 publications

(39 citation statements)

References 85 publications

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“…Both false-negative patients, however, had a previous history of radiotherapy treatment and it is known that previous (chemo)radiotherapy may impair the diagnosis of recurrence and that the most reliable technique to obtain a histological diagnosis would be via microlaryngoscopy under general anaesthesia [15]. The assessment of recurrent laryngeal carcinoma after (chemo)radiotherapy is much more difficult than the assessment of "de novo" carcinoma either by endoscopy or by imaging studies for various reasons: tumour may recur after radiation therapy in multicentric foci, undetectable by imaging studies, residual inflammation changes may be associated with radiotherapy, tumour recurrence may be localised submucosally and invisible during endoscopy [16].…”

Section: Discussionmentioning

confidence: 99%

US-guided transcutaneous tru-cut biopsy of laryngo-hypopharyngeal lesions

et al. 2009

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Objective: To evaluate the feasibility and performance of ultrasound-guided transcutaneous tru-cut biopsy (USGTCB) in selected patients (with stenosis of airways or difficult intubation or contraindication to general anaesthesia) with untreated or previously treated suspicious laryngo-hypopharyngeal masses. Methods: Biopsies were performed with a free-hand technique by a single radiologist. Thirty-six USGTCBs were scheduled in 34 patients (24 males, 10 females; age range 47-95 years). Two USGTCBs were not performed, as lesions were not detectable: therefore, 16 USGTCBs were performed for an untreated mass suspicious for malignancy and 18 were performed for a mass suspicious for recurrence after radiotherapy alone, or associated with endoscopic laser surgery or chemotherapy. Results: USGTCB diagnosed 25 squamous cell carcinomas (73.5%) and nine benign lesions (26.5%); no false positives and two false negatives were reported, both in patients previously treated with radiotherapy. The sensitivity, specificity, positive and negative predictive value of the technique was 92.5%, 100%, 100% and 77.7% respectively, with no major complications. Conclusion: Although biopsy under microlaryngoscopy remains the "gold-standard" technique, USGTCB is feasible, carries the advantages of avoiding general anaesthesia, is suitable for outpatients and is cost-effective. If applied to selected patients, it could be considered for the histological diagnosis of both primary and recurrent laryngo-hypopharyngeal masses.

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Section: Discussionmentioning

confidence: 99%

US-guided transcutaneous tru-cut biopsy of laryngo-hypopharyngeal lesions

et al. 2009

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“…It is also valuable in the investigation of patients with unknown primary, e.g., patients presenting only with neck mass. In addition, FDG-PET is used for followup after treatment when searching for recurrent disease or metastasis (3)(4)(5). However, FDG-PET has some inherent problems.…”

Section: Introductionmentioning

confidence: 99%

A novel CD44v6 targeting antibody fragment with improved tumor-to-blood ratio

Sandstrï¿1⁄2m

2012

Int J Oncol

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Abstract. The chimeric monoclonal antibody U36 (cMAb U36) recognizes the CD44v6 antigen. Its potential as a radioimmunotargeting agent, as well as its safety, has been shown in previous studies in head and neck cancer patients. However, intact MAbs have long circulation time in the blood and tumor targeting may also be hampered due to the slow and incomplete diffusion into solid tumors. In comparison, smaller monovalent Fab' and divalent F(ab') 2 fragments are expected to exhibit shorter circulating half-lives, better tumor penetration and are thus more likely to yield better imaging results. In this study, novel F(ab') 2 and Fab' fragments from cMAb U36 were radiolabeled with 125 I and the characteristics of the conjugates in vitro were examined. The biodistribution of the conjugates were then evaluated in nude mice bearing CD44v6-expressing xenograft tumors. Furthermore, the penetration depth and distribution in tumor tissue was assessed by autoradiography in selected tumor samples. The in vitro experiments showed that the conjugates were stable and had intact affinity to CD44v6. The biodistribution study demonstrated superior tumor-toblood ratio for the novel cMAb U36 fragment 125 I-F(ab') 2 compared with both the intact MAb and the monovalent fragment form. Autoradiography also revealed better tumor penetration for 125 I-F(ab') 2 . This study demonstrates that the use of antibody fragments may improve radioimmunotargeting and possibly improve the management of head and neck malignancies.

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“…The authors demonstrated a sensitivity of 89% and specificity of 74% of the PET-CT to differentiate between tumor recurrence and local actinic late alterations. It should therefore be the exam of choice to avoid unnecessary CT scans and laryngoscopies with biopsies 42,43,45 . The various treatments proposed for chondroradionecrosis included the use of antibiotic therapy, air humidifiers, corticosteroids, antireflux drugs (proton pump blockers, prokinetics) and hyperbaric chamber (HBC), the latter being in varied regimens.…”

Section: Discussionmentioning

confidence: 99%

Condroradionecrose de laringe após radioterapia

Melo

Souza

Filho

et al. 2017

Rev. Col. Bras. Cir.

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RESUMO Objetivo: estudar a condroradionecrose de laringe por complicação de radio-quimioterapia para tratamento do câncer de laringe e propor um fluxograma de tratamento com a utilização de câmara hiperbárica. Métodos: estudo retrospectivo de pacientes portadores de carcinoma de laringe admitidos em dois hospitais terciários num período de cinco anos. Resultados: de 131 pacientes portadores de câncer de laringe, 28 foram submetidos à radio e quimioterapia exclusiva e destes, três evoluíram com condroradionecrose. O tratamento destes pacientes foi realizado com câmara hiperbárica e com desbridamento cirúrgico, conforme proposição do fluxograma. Todos os pacientes tiveram a laringe preservada. Conclusão: a incidência de condroradionecrose de laringe por complicação de radioterapia e quimioterapia em nossa casuística foi de 10,7% e o tratamento com oxigenoterapia hiperbárica, com base no nosso fluxograma, foi efetivo no controle desta complicação.

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Systematic review: Accuracy of imaging tests in the diagnosis of recurrent laryngeal carcinoma after radiotherapy

Abstract: The diagnostic accuracy of 18FDG-PET is promising and warrants a randomized trial comparing a strategy based on conventional diagnostic work-up to one based on 18FDG-PET.

Cited by 43 publications

References 85 publications

US-guided transcutaneous tru-cut biopsy of laryngo-hypopharyngeal lesions

US-guided transcutaneous tru-cut biopsy of laryngo-hypopharyngeal lesions

A novel CD44v6 targeting antibody fragment with improved tumor-to-blood ratio

Condroradionecrose de laringe após radioterapia

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