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Utility of positron emission tomography for the detection of disease in residual neck nodes after (chemo)radiotherapy in head and neck cancer

✍ Scribed by Sandro V. Porceddu; Elizabeth Jarmolowski; Rodney J. Hicks; Rob Ware; LeAnn Weih; Danny Rischin; June Corry; Lester J. Peters

Publisher: John Wiley and Sons
Year: 2005
Tongue: English
Weight: 217 KB
Volume: 27
Category: Article
ISSN: 1043-3074
DOI: 10.1002/hed.20130

No coin nor oath required. For personal study only.

✦ Synopsis

Background. This study evaluates the utility of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET) in patients with a node-positive mucosal head and neck squamous cell carcinoma who achieved a complete response at the primary site but had a residual mass in the neck 8 weeks or more after definitive (chemo)radiotherapy.

Methods. Between October 1996 and July 2002, 39 eligible patients were identified. The reference PET scan was performed at a median of 12 weeks (range, 8 -32 weeks) after treatment.

Results. PET showed no metabolic activity in the residual mass in 32 patients. Five of these patients had a neck dissection and were all pathologically negative. The remaining 27 patients were observed for a median of 34 months (range, 16 -86 months), with only one locoregional failure. The negative predictive value of PET for viable disease in a residual anatomic abnormality was 97%.

Conclusion. Patients who have achieved a complete response at the primary site but have a residual abnormality in the neck that is PET negative approximately 12 weeks after treatment do not require neck dissection and can be safely observed.

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