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Title: Utility of PET/CT Imaging Performed Early After Surgical Resection in the Adjuvant Treatment Planning for Head and Neck Cancer

Abstract

Purpose: To evaluate the utility of positron emission tomography (PET)/computed tomography (CT) early after surgical resection and before postoperative adjuvant radiation therapy. Methods and Materials: We studied a prospective cohort of 91 consecutive patients referred for postoperative adjuvant radiation therapy after complete surgical resection. Tumor histologies included 62 squamous cell and 29 non-squamous cell cancers. Median time between surgery and postoperative PET/CT was 28 days (range, 13-75 days). Findings suspicious for persistent/recurrent cancer or distant metastasis were biopsied. Correlation was made with changes in patient care. Results: Based on PET/CT findings, 24 patients (26.4%) underwent biopsy of suspicious sites. Three patients with suspicious findings did not undergo biopsy because the abnormalities were not easily accessible. Eleven (45.8%) biopsies were positive for cancer. Treatment was changed for 14 (15.4%) patients (11 positive biopsy and 3 nonbiopsied patients) as a result. Treatment changes included abandonment of radiation therapy and switching to palliative chemotherapy or hospice care (4), increasing the radiation therapy dose (6), extending the radiation therapy treatment volume and increasing the dose (1), additional surgery (2), and adding palliative chemotherapy to palliative radiation therapy (1). Treatment for recurrent cancer and primary skin cancer were significant predictors of having a biopsy-proven, treatment-changingmore » positive PET/CT (p < 0.03). Conclusions: Even with an expectedly high rate of false positive PET/CT scans in this early postoperative period, PET/CT changed patient management in a relatively large proportion of patients. PET/CT can be recommended in the postoperative, preradiation therapy setting with the understanding that treatment-altering PET/CT findings should be biopsied for confirmation.« less

Authors:
 [1];  [2]; ;  [3];  [4]
  1. Department of Otolaryngology-Head and Neck Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL (United States)
  2. Department of Diagnostic Radiology, Mayo Clinic College of Medicine, Rochester, MN (United States)
  3. Department of Radiation Oncology, Mayo Clinic College of Medicine, Rochester, MN (United States)
  4. Department of Otorhinolaryngology, Mayo Clinic College of Medicine, Rochester, MN (United States)
Publication Date:
OSTI Identifier:
21039735
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 70; Journal Issue: 2; Other Information: DOI: 10.1016/j.ijrobp.2007.06.038; PII: S0360-3016(07)01148-0; Copyright (c) 2008 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOPSY; CHEMOTHERAPY; COMPUTERIZED TOMOGRAPHY; CORRELATIONS; HEAD; HISTOLOGY; METASTASES; NECK; NEOPLASMS; PATIENTS; PLANNING; POSITRON COMPUTED TOMOGRAPHY; RADIATION DOSES; RADIOTHERAPY; SURGERY

Citation Formats

Shintani, Stephanie A, Foote, Robert L., Lowe, Val J, Brown, Paul D, Garces, Yolanda I, and Kasperbauer, Jan L. Utility of PET/CT Imaging Performed Early After Surgical Resection in the Adjuvant Treatment Planning for Head and Neck Cancer. United States: N. p., 2008. Web. doi:10.1016/j.ijrobp.2007.06.038.
Shintani, Stephanie A, Foote, Robert L., Lowe, Val J, Brown, Paul D, Garces, Yolanda I, & Kasperbauer, Jan L. Utility of PET/CT Imaging Performed Early After Surgical Resection in the Adjuvant Treatment Planning for Head and Neck Cancer. United States. https://doi.org/10.1016/j.ijrobp.2007.06.038
Shintani, Stephanie A, Foote, Robert L., Lowe, Val J, Brown, Paul D, Garces, Yolanda I, and Kasperbauer, Jan L. 2008. "Utility of PET/CT Imaging Performed Early After Surgical Resection in the Adjuvant Treatment Planning for Head and Neck Cancer". United States. https://doi.org/10.1016/j.ijrobp.2007.06.038.
@article{osti_21039735,
title = {Utility of PET/CT Imaging Performed Early After Surgical Resection in the Adjuvant Treatment Planning for Head and Neck Cancer},
author = {Shintani, Stephanie A and Foote, Robert L. and Lowe, Val J and Brown, Paul D and Garces, Yolanda I and Kasperbauer, Jan L},
abstractNote = {Purpose: To evaluate the utility of positron emission tomography (PET)/computed tomography (CT) early after surgical resection and before postoperative adjuvant radiation therapy. Methods and Materials: We studied a prospective cohort of 91 consecutive patients referred for postoperative adjuvant radiation therapy after complete surgical resection. Tumor histologies included 62 squamous cell and 29 non-squamous cell cancers. Median time between surgery and postoperative PET/CT was 28 days (range, 13-75 days). Findings suspicious for persistent/recurrent cancer or distant metastasis were biopsied. Correlation was made with changes in patient care. Results: Based on PET/CT findings, 24 patients (26.4%) underwent biopsy of suspicious sites. Three patients with suspicious findings did not undergo biopsy because the abnormalities were not easily accessible. Eleven (45.8%) biopsies were positive for cancer. Treatment was changed for 14 (15.4%) patients (11 positive biopsy and 3 nonbiopsied patients) as a result. Treatment changes included abandonment of radiation therapy and switching to palliative chemotherapy or hospice care (4), increasing the radiation therapy dose (6), extending the radiation therapy treatment volume and increasing the dose (1), additional surgery (2), and adding palliative chemotherapy to palliative radiation therapy (1). Treatment for recurrent cancer and primary skin cancer were significant predictors of having a biopsy-proven, treatment-changing positive PET/CT (p < 0.03). Conclusions: Even with an expectedly high rate of false positive PET/CT scans in this early postoperative period, PET/CT changed patient management in a relatively large proportion of patients. PET/CT can be recommended in the postoperative, preradiation therapy setting with the understanding that treatment-altering PET/CT findings should be biopsied for confirmation.},
doi = {10.1016/j.ijrobp.2007.06.038},
url = {https://www.osti.gov/biblio/21039735}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 2,
volume = 70,
place = {United States},
year = {Fri Feb 01 00:00:00 EST 2008},
month = {Fri Feb 01 00:00:00 EST 2008}
}