Impact of initial FDG PET/CT in the management plan of patients with locally advanced head and neck cancer
Arias F (1), Chicata V, García-Velloso MJ, Asín G, Uzcanga M, Eito C, Quilez I, Viudez A, Saenz J, Hernández I, Caicedo C, Errasti M, Barrado M, García-Bragado F.
(1) Service of Radiation Oncology, Complejo Hospitalario de Navarra, 3, Irunlarrea, 31008, Pamplona, Navarra, Spain,
To determine the impact of initial FDG PET/CT staging on clinical stage and the management plan in patients with locally advanced head and neck cancer (LAHNC).
MATERIALS AND METHODS:
We retrospectively reviewed the records of 72 consecutive patients (2007-2010) staged with PET/CT and conventional CT with tumours of hypopharynx/larynx (26 patients, 36 %), oral cavity (17 patients, 24 %), oropharynx (16 patients, 22 %), nasopharynx (12 patients, 17 %), and others (2 %). The impact of PET/CT on management plans was considered high when PET/CT changed the planned treatment modality or treatment intent, and intramodality changes were considered as minor changes with low impact.
FDG PET/CT changed the stage in 27 patients and had high impact on the management plan in 12 % of patients (detection of distant metastases in 6 patients and stage II in 2 patients). Intramodality changes were more frequent: FDG PET/CT altered the TNM stage in 18/72 (25 %) of patients, upstaging N stage in 90 % of patients with low impact.
Initial FDG PET/CT staging not only improves stage but also affects the management plan in LAHNC patients.
CITATION Clin Transl Oncol. 2015 Feb;17(2):139-44. doi: 10.1007/s12094-014-1204-8. Epub 2014 Jul 31