The Role of Positron Emission Tomography/Computed Tomography Imaging in Head and Neck Cancer after Radical Chemoradiotherapy: a Single Institution Experience

Nelissen, C.; Sherriff, Jenny; Jones, T.S.; Guest, Peter; Colley, Steve; Sanghera, Paul; Hartley, A.

doi:10.1016/j.clon.2017.07.010

Cited by 10 publications

(12 citation statements)

References 34 publications

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“…Response assessment FDG PET-CT is well-established following chemoradiotherapy with a high NPV at primary site and lymph nodes [7][8][9][10][11]. It has been shown to be possible to spare patients a neck dissection without compromising outcomes in the event of a complete response on PET-CT [2].…”

Section: Discussionmentioning

confidence: 99%

“…When there is doubt about clinical and radiological response a 'second-look' PET-CT can be used to spare patients unnecessary surgical intervention Introduction Accurate response assessment following (chemo)radiotherapy for head and neck squamous cell carcinoma (HNSCC) is required to select patients for clinical follow up from those who require surgical treatment. The difficulty in determining the significance of residual masses post-treatment limits the utility of anatomical imaging with CT and/or MRI [ The negative predictive values (NPV) of response assessment FDG PET-CT have been shown to be excellent, identifying patients who do not require surgical intervention [6][7][8][9][10][11][12][13][14]. This applies even in the context of metabolically inactive residual masses [8; 15].…”

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confidence: 99%

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Second-look PET-CT following an initial incomplete PET-CT response to (chemo)radiotherapy for head and neck squamous cell carcinoma

Prestwich

Arunsingh²,

Zhong³

et al. 2019

Eur Radiol

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Second-look PET-CT following an initial incomplete PET-CT response to (chemo)radiotherapy for head and neck squamous cell carcinoma

Prestwich

Arunsingh²,

Zhong³

et al. 2019

Eur Radiol

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“…CT (8/93%) [27] showed similar NPV to DW MRI (71% [25] and 97% [24]), followed by MRI with 76% [24]. Other authors have investigated the use of FDG PET/CT in restaging after HNSCC [25,[27][28][29][30][31][32]. The patient cohorts were not focused on laryngeal carcinoma.…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, the three articles analyzed in this review are the only publications focusing on restaging of laryngeal carcinoma after RT, CRT, or radioimmunotherapy in the past 10 years. For the detection of residual or recurrent HNSCC, the sensitivity of FDG PET/CT ranges from 71 to 97%, whereas specificity ranges from 46 to 92%, the PPV ranges from 64 to 71%, and the NPV from 86 to 98% [25,27,31,33]. Analyzing the studies in Table 1, the sensitivity of FDG PET/CT for detecting residual laryngeal carcinoma ranges from 33 to 75%, specificity from 53to 86%, PPV from 40 to 67%, and NPV from 73 to 86%.…”

Section: Discussionmentioning

confidence: 99%

Routine restaging after primary non-surgical treatment of laryngeal squamous cell carcinoma—a review

et al. 2020

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Purpose Treatment of patients with laryngeal squamous cell carcinoma with radiotherapy or chemoradiation is an established alternative to laryngeal surgery in many cases, but particularly for advanced tumors without cartilage invasion. Imaging modalities face the challenge of distinguishing between posttherapeutic changes and residual disease in the complex anatomic subsite of the larynx. Guidelines concerning restaging of head and neck squamous cell carcinomas (HNSCC) are presented by the National Comprehensive Cancer Network (NCCN) and other national guidelines, but clearly defined recommendations for routine restaging particularly for laryngeal cancer are lacking. Methods A systematic search was carried out in PubMed to identify studies evaluating routine restaging methods after primary non-surgical treatment of laryngeal squamous cell carcinoma from 2009 to 2020. Results Only three studies were deemed eligible, as they included at least ≥50% patients with laryngeal squamous cell carcinoma and evaluated imaging modalities to detect residual cancer. The small number of studies in our review suggest restaging with fluoro-deoxy-glucose positron-emission tomography/computed tomography (FDG PET/CT) 3 months after initial treatment, followed by direct laryngoscopy with biopsy of the lesions identified by FDG PET/CT. Conclusion Studies evaluating restaging methods after organ-preserving non-surgical treatment of laryngeal carcinoma are limited. As radiotherapy (RT), chemoradiotherapy (CRT), systemic therapy followed by RT and radioimmunotherapy are established alternatives to surgical treatment, particularly in advanced laryngeal cancers, further studies are needed to assess and compare different imaging modalities (e.g. PET/CT, MRI, CT, ultrasound) and clinical diagnostic tools (e.g., video laryngoscopy, direct laryngoscopy) to offer patients safe and efficient restaging strategies. PET or PET/CT 3 months after initial treatment followed by direct laryngoscopy with biopsy of the identified lesions has the potential to reduce the number of unnecessary laryngoscopies.

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“…In the PET NECKstudy, PET CT guided follow up of the irradiated neck was associated with a similar survival and lower costs when compared with planned neck dissection [ 53 ]. Many studies of the role of PET CT in this setting focus on the high negative predictive value for subsequent primary site and nodal recurrence across a spectrum of head and neck anatomical sites [ 54 ]. This underlines the utility of PET CT as a modality for comparing efficacy after novel interventions.…”

Section: The Role Of Pet Ct In Response Assessment Following Treatmentioning

confidence: 99%

Assessing Novel Drugs and Radiation Technology in the Chemoradiation of Oropharyngeal Cancer

et al. 2018

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Integrating immunotherapy, proton therapy and biological dose escalation into the definitive chemoradiation of oropharyngeal cancer poses several challenges. Reliable and reproducible data must be obtained in a timely fashion. However, despite recent international radiotherapy contouring guidelines, controversy persists as to the applicability of such guidelines to all cases. Similarly, a lack of consensus exists concerning both the definition of the organ at risk for oral mucositis and the most appropriate endpoint to measure for this critical toxicity. Finally, the correlation between early markers of efficacy such as complete response on PET CT following treatment and subsequent survival needs elucidation for biological subsets of oropharyngeal cancer.

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The Role of Positron Emission Tomography/Computed Tomography Imaging in Head and Neck Cancer after Radical Chemoradiotherapy: a Single Institution Experience

Cited by 10 publications

References 34 publications

Second-look PET-CT following an initial incomplete PET-CT response to (chemo)radiotherapy for head and neck squamous cell carcinoma

Second-look PET-CT following an initial incomplete PET-CT response to (chemo)radiotherapy for head and neck squamous cell carcinoma

Routine restaging after primary non-surgical treatment of laryngeal squamous cell carcinoma—a review

Assessing Novel Drugs and Radiation Technology in the Chemoradiation of Oropharyngeal Cancer

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