PET Changes Management and Improves Prognostic Stratification in Patients with Head and Neck Cancer: Results of a Multicenter Prospective Study

¹ Centre for PET and Department of Medicine, University of Melbourne, Melbourne, Australia; Ludwig Institute for Cancer Research, Austin Hospital, Melbourne, Australia
² Centre for PET and Department of Medicine, University of Melbourne, Melbourne, Australia
³ Department of Nuclear Medicine, PET and Bone Densitometry, Royal Adelaide Hospital, Adelaide, Australia
⁴ Australian and New Zealand Association of Physicians in Nuclear Medicine, Melbourne, Australia
⁵ Department of Nuclear Medicine and PET, Liverpool Hospital, Sydney, Australia

^* To whom correspondence should be addressed. E-mail: andrew.scott{at}ludwig.edu.au.

	Abstract

The primary aim of this study was to determine the impact of PET in changing initial management plans in patients with untreated head and neck cancer. Secondary aims were to determine the incremental staging information provided by PET and to document the effect of PET on treatment outcomes. Methods: Patients with untreated head and neck cancer underwent PET scans. Pre-PET management plans were documented by referring clinicians unaware of the PET results, and management plan changes due to PET scan findings were documented. Follow-up to 12 mo after treatment was performed to determine actual management and clinical outcomes. Results: A total of 71 patients (median age, 56 y; 69% male) were studied. PET scans resulted in management change in 33.8% of patients. Moreover, PET was able to detect additional sites of disease in 39.4% of patients. Follow-up data showed that PET improved the classification of patients into curative and palliative categories. Trends toward inferior disease-free survival and lower complete response rates in patients with additional lesions detected on PET were demonstrated. In addition, a trend toward inferior disease-free survival in patients with a higher maximum standardized uptake value was shown. Conclusion: These data unequivocally demonstrate the significant impact of PET on management and outcomes in patients with untreated head and neck cancer.

Key Words: PET, head and neck cancer

This article has been cited by other articles:

				M. Lonneux, M. Hamoir, H. Reychler, P. Maingon, C. Duvillard, G. Calais, B. Bridji, L. Digue, M. Toubeau, and V. Gregoire Positron Emission Tomography With [18F]Fluorodeoxyglucose Improves Staging and Patient Management in Patients With Head and Neck Squamous Cell Carcinoma: A Multicenter Prospective Study J. Clin. Oncol., March 1, 2010; 28(7): 1190 - 1195. [Abstract] [Full Text] [PDF]

				R. S. Rodrigues, F. A. Bozza, P. E. Christian, J. M. Hoffman, R. I. Butterfield, C. R. Christensen, M. Heilbrun, R. H. Wiggins III, J. P. Hunt, B. G. Bentz, et al. Comparison of Whole-Body PET/CT, Dedicated High-Resolution Head and Neck PET/CT, and Contrast-Enhanced CT in Preoperative Staging of Clinically M0 Squamous Cell Carcinoma of the Head and Neck J. Nucl. Med., August 1, 2009; 50(8): 1205 - 1213. [Abstract] [Full Text] [PDF]

				D. A. Podoloff, D. W. Ball, E. Ben-Josef, A. B. Benson III, S. J. Cohen, R. E. Coleman, D. Delbeke, M. Ho, D. H. Ilson, G. P. Kalemkerian, et al. NCCN Task Force: Clinical Utility of PET in a Variety of Tumor Types J Natl Compr Canc Netw, June 1, 2009; 7(Suppl_2): S-1 - S-23. [Abstract] [PDF]