Early PET-CT predicts treatment response of head and neck cancer

Source: www.curetoday.com Author: staff In patients with advanced squamous cell carcinoma of the head and neck, negative findings on post-treatment positron emission tomography/computed tomography (PET-CT) predict a good treatment response, researchers say. In 31 patients with clinical stage III and IV tumors treated with cisplatin and concurrent external beam radiotherapy, PET-CT was performed 6 to 8 weeks after therapy was completed, along with a comprehensive physical examination of the head and neck, as reported by Dr. James P. Malone, from the Southern Illinois School of Medicine, Springfield, and colleagues in the November Archives of Otolaryngology -- Head and Neck Surgery. Seventeen patients had evidence of persistent disease on physical exam, CT, and/or PET-CT, and these individuals had surgery for further evaluation. Fourteen patients had complete clinical responses, including no evidence of FDG uptake on PET-CT; these subjects were observed with routine follow-up. According to the researchers, all but one of these 14 patients remained disease free at the primary tumor site during a median follow-up of 26 months. Thus, the authors point out, the sensitivity of PET-CT was 83%, and its negative predictive value was "excellent" at 92% for detection of persistent disease at the primary tumor site. Because of a high false-positive rate, specificity was low at 54%, with a positive predictive value of 31%. Dr. Malone's group attributes the high false-positive rate to inflammation related to recent treatment. The investigators also note that 5 of 16 patients with abnormal FDG update developed local disease. "For patients with abnormal [...]

2009-11-18T16:19:03-07:00November, 2009|Oral Cancer News|

Unnecessary Biopsies Reduced By Team Work, St. Louis University Researchers Find

Source: www.medicalnewstoday.com Author: press release Unnecessary biopsies could be a thing of the past for patients undergoing treatment for head and neck cancer. New Saint Louis University research found that when nuclear medicine clinicians and treating physicians work together to interpret PET-CT scan results, the accuracy dramatically improves, sparring patients unnecessary pain and suffering. Often used prior to and after cancer treatment, the highly sensitive PET-CT has improved the ability to detect and treat head and neck cancer. However, it can give a significant number of false positive results, which then require a biopsy to rule out cancer that could have been left behind during the initial treatment. According to Mark Varvares, M.D., the study's lead author and the Donald and Marlene Jerome Endowed Chair in Otolaryngology - Head and Neck Surgery at Saint Louis University, both nuclear medicine and treating physicians have become better at interpreting PET-CT scans. "If we improve the accuracy of the scans by including clinical information, the treating physician or cancer specialist will be able to say with confidence that we do not need to biopsy something - that it's just post-operative inflammation." Unnecessary biopsies are dangerous for head and neck cancer patients who have already undergone intensive radiation and chemotherapy. It can create a non-healing situation that can result in a catastrophic event, such as needing to remove the voice box, Varvares explained. Varvares and his colleagues studied the scan results of 180 head and neck cancer patients who had undergone evaluation with PET-CT [...]

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