TY - JOUR T1 - Positive Clinical Impact of an Additional PET/CT Scan Before Adjuvant Radiotherapy or Concurrent Chemoradiotherapy in Patients with Advanced Oral Cavity Squamous Cell Carcinoma JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 22 LP - 30 DO - 10.2967/jnumed.114.145300 VL - 56 IS - 1 AU - Chung-Jan Kang AU - Chien-Yu Lin AU - Lan-Yan Yang AU - Tsung-Ying Ho AU - Li-Yu Lee AU - Kang-Hsing Fan AU - Hung-Ming Wang AU - Shiang-Fu Huang AU - Kai-Ping Chang AU - Ku-Hao Fang AU - Shu-Hang Ng AU - Chun-Ta Liao AU - Tzu-Chen Yen Y1 - 2015/01/01 UR - http://jnm.snmjournals.org/content/56/1/22.abstract N2 - The aim of this single-center study was to investigate whether obtaining an additional PET/CT scan before adjuvant radiotherapy or concurrent chemoradiotherapy (CCRT) could meaningfully improve 2-y disease-free survival (DFS) and disease-specific survival (DSS) rates. Methods: Six hundred seventy-four patients with oral cavity squamous cell carcinoma who received adjuvant therapy after radical surgery were included. Of these, 152 patients were initially scheduled to receive an additional preradiotherapy/CCRT PET/CT scan within 1 wk of starting adjuvant therapy. However, 16 patients were excluded because of either medical problems or refusal. Therefore, 136 patients underwent a preradiotherapy/CCRT PET/CT scan (PET group), and 522 did not (NO-PET group). All of the participants were followed up for at least 2 y or censored at the last follow-up. The impact of preradiotherapy/CCRT PET/CT imaging was examined using Kaplan–Meier curves and Cox proportional hazards models. Results: Two-year DFS (80% vs. 70%, P = 0.033) and DSS (84% vs. 75%, P = 0.010) rates were significantly higher in the PET than in the NO-PET group. In the PET group, both DFS and DSS were higher in patients with negative findings than in those without (88% vs. 22% and 91% vs. 36%, respectively; both P < 0.001). A prognostic scoring system based on the presence of the 2 independent risk factors in the PET group (extracapsular spread and lymphatic invasion) predicted both DFS (P = 0.001 and P < 0.001, respectively) and DSS (P = 0.001 and P < 0.001, respectively). Nineteen patients (14%) had their treatment modified by preradiotherapy/CCRT PET/CT findings. Of these, 15 were treated with curative intent due to the presence of locoregional disease, and 4 received palliative care due to distant metastases. Seven of the 15 patients are currently alive without disease. Conclusion: An additional preradiotherapy/CCRT PET/CT scan improves both DFS and DSS in patients with advanced oral cavity squamous cell carcinoma. ER -