Imaging, physical examination find most recurrences of HPV-positive oropharyngeal cancer

Source: www.oncologynurseadvisor.com Author: Kathy Boltz, PhD Posttreatment imaging at 3 months and physical examinations during the 6 months following treatment can detect most recurrences in patients treated with definitive radiation therapy for oropharyngeal cancer caused by human papillomavirus (HPV).1 This research was presented at the 2016 Multidisciplinary Head and Neck Cancer Symposium. A dramatic increase in oropharyngeal squamous cell carcinoma (OPSCC) cases associated with HPV has been reported by the American Cancer Society. Survival rates after definitive radiation therapy have also increased. This has led to the need to determine general time to recurrence and the most effective modes of recurrence detection, to guide standards for optimal follow-up care by oncology teams. This study examined 246 cases of HPV-positive or p16-positive non-metastatic OPSCC treated with definitive radiation therapy at a single, large-volume cancer center between 2006 and 2014. Follow-up care included a PET/CT scan 3 months after completing treatment and physical examinations every 3 months in the first year following treatment, every 4 months in the second year and every 6 months in years 3 through 5. Median follow-up care length for all patients was 36 months. Patient outcomes, including recurrence and survival rates, were calculated using the Kaplan-Meier method from the end of radiation therapy. Most recurrences were detected either by persistent disease appearing on 3-month post-treatment imaging or by patients presenting with symptoms at follow-up examinations. Disease characteristics that increase the likelihood of recurrence include presenting with 5 or more nodes or having level 4 lymph nodes (P [...]

Journal of Nuclear Medicine: 18F-FDG PET+CT cost-effective in screening head and neck cancer patients

Source: www.healthimaging.com Author: staff Whole-body 18F-FDG PET combined with chest CT is cost-effective in pretreatment screening for distant metastases in head and neck squamous cell carcinoma (HNSCC) patients with risk factors, according to a study published in the February issue of the Journal of Nuclear Medicine. The presence of distant metastases at initial evaluation influences the prognosis and the treatment choice in HNSCC patients and hybrid PET/CT scanners was superior in sensitivity and cost effective when compared to FDG PET and CT alone, according to Otto S. Hoekstra, MD, PhD, of the VU University Medical Center in Amsterdam. In the study, 145 patients underwent chest CT and whole-body 18F-FDG PET for screening of distant metastases. The researchers analyzed the cost data of 80 patients in whom distant metastases developed or who had a follow-up of at least 12 months. Hoekstra said that cost-effectiveness analysis, including sensitivity analysis, was performed to compare the results of 18F-FDG PET, CT and a combination of CT and 18F-FDG PET. Hoekstra and colleagues identified distant metastases in 21 percent of patients by pretreatment screening. According to Hoekstra and colleagues, CT plus 18F-FDG PET had the highest sensitivity of 63 percent, while 18F-FDG PET had a sensitivity of 53 percent versus 37 percent with CTand positive predictive value of 80 percent versus 75 percent with CT. “CT + 18F-FDG PET resulted in savings between €203 ($303) and €604 ($903) ”, wrote Hoekstra and colleagues. The average costs in the CT + 18F-FDG PET group was found [...]

2010-02-23T12:55:19-07:00February, 2010|Oral Cancer News|

The Australian PET Data Collection Project is amassing more evidence that shows that PET positively changes management plans for cancer patients

Source: Journal of Nuclear Medicine (October 2008, Vol. 49:10, pp. 1593-1599) Author: Dr. Andrew Scott et al. Led by Dr. Andrew Scott, director of the Centre for PET at Austin Hospital in Melbourne, the newest research shows that PET provides important prognostic information in a large proportion of patients with untreated head and neck cancer, and detects additional sites of disease. The prospective study, published in the October issue of the Journal of Nuclear Medicine (October 2008, Vol. 49:10, pp. 1593-1599), was conducted at three Australian PET centers between December 17, 2003, and June 3, 2005. The criteria for enrollment included patients who previously had untreated carcinoma of the nasal cavity, nasopharynx, oral cavity, oropharynx, hypopharynx, or larynx, or had metastatic disease involving cervical lymph nodes from an unknown primary. Patients underwent examination under anesthesia and biopsy to confirm their diagnosis of cancer. Contrast-enhanced CT of the neck was required within six weeks of the PET scan. Patients fasted for a minimum of six hours before the PET study and received a dose of 120-440 MBq FDG intravenously. After a minimum uptake period of 45 minutes, researchers acquired PET data from the skull vertex to at least the lower abdomen. Treatment plans Before receiving the results of the PET scans, researchers asked referring clinicians to document their management plan for the patient, as if PET findings were not available, but with access to all other clinical and conventional imaging results. The management plan provided information on options such as surgery, [...]

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