PET/CT Planning Beneficial for Head and Neck Cancer Patients

	Tweet

Using a combination of positron emission tomography (PET) and computed tomography for radiation therapy treatment planning in head and neck carcinoma patients provides for excellent, local and regional disease control when compared to CT alone, according to a study in the March 1 issue of the International Journal for Radiation Oncology*Biology*Physics, the official journal of the American Society for Therapeutic Radiology and Oncology.

CT has been the traditional choice for staging and radiation therapy treatment planning for head and neck squamous cell carcinomas, which account for approximately 5 percent of malignancies worldwide; but PET has been shown to have advantages over CT and other imaging modalities in detecting primary tumors, involved lymph nodes and distant metastatic disease not clearly otherwise identified. PET alone does have several disadvantages though, such as poor correlation to precise anatomic structures, but these negative impacts are significantly reduced when PET and CT are combined by fusing the separate scans taken on a hybrid scanner.

While it has been proven in several studies that PET/CT imaging is feasible for head and neck radiation therapy planning, very few studies have been done to determine the clinical outcomes.

So, researchers in the departments of Radiation Oncology, Radiology, Neoplastic and Related Disorders, and Otolaryngology at the Medical College of Wisconsin in Milwaukee conducted this study to evaluate the clinical outcomes, including overall survival, disease-free survival and the incidence of recurrence of patients receiving PET/CT-guided radiation therapy and the correlation of the clinical outcomes to the maximum standard uptake value obtained on the PET scan.

Between December 2002 and August 2006, 42 patients with a median age of 55, who were diagnosed with head and neck squamous cell carcinoma, were given PET/CT imaging as part of their radiation therapy planning. All patients were observed for at least six months following their treatment, with a mean follow-up time of 32 months.

Overall survival of the 42 study patients was 82.8 percent at two years and 74.1 percent at three years, superior to the survival rate that was found in a Radiation Therapy Oncology Group study in which patients received standard fractionation or accelerated fractionation with concomitant boost. That study was the largest randomized trial of radiation therapy in locally advanced head and neck cancer.

Disease free survival for the 42 study patients was 71 percent and 66.9 percent at two and three years respectively. The cumulative incidence of recurrence was 18.7 percent. The study also found that standard uptake value is not a good predictor of local recurrence and that dose escalation based on standard uptake value is unlikely to be a fruitful treatment strategy.

“PET/CT provides a higher level of confidence that we are not missing tumors as we attempt to lessen treatment side effects by delivering radiation therapy that tightly conforms in three dimensions to a given tumor volume,” said Christopher Schultz, M.D., professor of radiation oncology at the Medical College of Wisconsin. “Most importantly the PET/CT guided conformal radiotherapy was clearly no worse, and based on our early results may in fact lead to superior clinical outcomes as compared to CT only planned radiotherapy.”

ASTRO is the largest radiation oncology society in the world, with 9,000 members who specialize in treating patients with radiation therapies. As the leading organization in radiation oncology, biology and physics, the Society is dedicated to improving patient care through education, clinical practice, advancement of science and advocacy.

Source: American Society for Therapeutic Radiology and Oncology (ASTRO)

RELATED STORIES:
Study finds 231 new genes associated with head and neck cancer   Cancer sequencing initiative discovers mutations tied to aggressive childhood brain tumors   New procedure to make brain surgery safer   Do cell phones increase brain cancer risk?   Determining the genetic composition of brain cancers informs treatment, predicts outcome   Sensitizing tumor response to cancer therapy   Study Finds Promising Chemoradiation Therapy   Coffee may cut risk of head and neck cancers   Some brain tumors mimic the genetic program of germline cells   Brain metastases hijack neuron-supporting cells to resist chemotherapy   Psychiatric symptoms can be first sign of cancer   Hyperbaric Oxygen Tested for Aggressive Brain Cancer   Prenatal Vitamins May Reduce Risk of Brain Tumors in Children   Tooth Loss Linked to Esophageal, Head and Neck, and Lung Cancer   Recurrent Brain Cancer Responds to New Treatment   Tobacco use linked to worse outcomes in HPV-positive head and neck cancer, U-M study finds   Genetic Risk Factor Found for Head and Neck Cancer in Smokers   Physical activity in adolescence associated with decreased risk of brain cancer in adulthood   Combining CT, FDG-PET provides more accurate treatments for head and neck cancer patients   New Insight on Survival for Patients with Head and Neck Cancers   Protein Expression Holds Promise for Head and Neck Cancer Detection   Brain tumor discovery could lead to new treatment

Comments

[ + Post Your Own ]

Now you're in the public comment zone. What follows is not Armenian Medical Network's stuff; it comes from other people and we don't vouch for it. A reminder: By using this Web site you agree to accept our Terms of Service. Click here to read the Rules of Engagement.

There are no comments for this entry yet. [ + Comment here + ]