surveillance – Oral Cancer News

‘Paradoxical’ data show routine imaging lacks benefit for head and neck cancer survivors

Source: www.healio.com Author: Matthew Shinkle Key takeaways: Researchers saw no statistical difference between patient groups with respect to treatment outcomes. Larger studies are needed to further evaluate this study’s findings. Compared with expectant management, imaging-based surveillance did not improve outcomes among patients in remission after completion of primary radiation therapy for head and neck cancer, according to data published in JAMA Network Open. Although imaging “in the context of clinical suspicion” for this specific patient population is common and typically beneficial, according to researchers, the results of this study show that such a practice is not valuable for asymptomatic patients. “The results of the present study, while seemingly paradoxical, are consistent with those of others which have failed to demonstrate a benefit to surveillance imaging among patients who have successfully completed treatment for head and neck cancer,” Allen M. Chen, MD, MBA, professor and chair of the department of radiation oncology at University of California, Irvine, Chao Family Comprehensive Cancer Center, and researchers wrote. Researchers conducted a retrospective, comparative effectiveness review to evaluate the potential benefit of surveillance imaging among asymptomatic patients with head and neck cancer currently in remission following completion of chemoradiation. The study included 340 adults (59% men; 43% white) who had achieved a complete metabolic response to initial treatment for newly diagnosed squamous cell carcinoma of the head and neck between January 2014 and June 2022. Researchers defined surveillance imaging as the acquisition of a PET with CT, MRI or CT of the head and neck [...]

Oral Cancer Foundation News Team - A2024-03-14T16:33:37-07:00March, 2024|Oral Cancer News|

Nonsurgical surveillance safe, cost-effective for head, neck cancer

Source: www.healio.com Author: Mehanna H, et al. Patients with head and neck cancer who underwent PET/CT–guided surveillance achieved similar survival outcomes as those who underwent planned neck dissections, according to the results of a prospective, randomized controlled trial. However, surveillance led to fewer surgical operations and complications and appeared more cost-effective than neck dissection, results showed. Patients with head and neck cancer frequently undergo invasive surgery following treatment to remove remaining cancer cells, according to study background. “After treatment, remaining cancer cells play something akin to hide and seek,” Hisham Mehanna, MBChB, PhD, FRCS, chair of head and neck surgery at University of Birmingham and director of the Institute of Head and Neck Studies and Education, said in a press release. “Our study shows that we can hunt them down, find them and remove them effectively.” Mehanna and colleagues sought to define the role of image-guided surveillance compared with planned neck dissection for the management of patients with advanced, nodal head and neck squamous cell carcinoma previously treated with primary chemoradiotherapy. The analysis included data from 564 patients (mean age, 58 years; 82% men) who researchers randomly assigned to PET/CT–guided surveillance (n = 282) performed 12 weeks after the end of treatment or planned neck dissection (n = 282). Oropharyngeal cancer served as the most common cancer subtype (84%). Seventy-five percent of patients had HPV-16–positive disease. Patients assigned surveillance only underwent neck dissection if their PET/CT scans showed incomplete or equivocal response to chemoradiotherapy. The trial was designed to assess [...]

Oral Cancer Foundation News Team - A2016-03-24T09:07:04-07:00March, 2016|Oral Cancer News|

The lack of evidence for PET or PET/CT surveillance of patients with treated lymphoma, colorectal cancer, and head and neck cancer: a systematic review

Source: jnm.snmjournals.org Authors: Kamal Patel et al PET and PET/CT are widely used for surveillance of patients after cancer treatments. We conducted a systematic review to assess the diagnostic accuracy and clinical impact of PET and PET/CT used for surveillance in several cancers. Methods: We searched MEDLINE and Cochrane Library databases from 1996 to March 2012 for English-language studies of PET or PET/CT used for surveillance of patients with lymphoma, colorectal cancer, or head and neck cancer. We included prospective or retrospective studies that reported test accuracy and comparative studies that assessed clinical impact. Results: Twelve studies met our inclusion criteria: 6 lymphoma (n = 767 patients), 2 colorectal cancer (n = 96), and 4 head and neck cancer (n = 194). All studies lacked a uniform definition of surveillance and scan protocols. Half the studies were retrospective, and a third were rated as low quality. The majority reported sensitivities and specificities in the range of 90%–100%, although several studies reported lower results. The only randomized controlled trial, a colorectal cancer study with 65 patients in the surveillance arm, reported earlier detection of recurrences with PET and suggested improved clinical outcomes. Conclusion: There is insufficient evidence to draw conclusions on the clinical impact of PET or PET/CT surveillance for these cancers. The lack of standard definitions for surveillance, heterogeneous scanning protocols, and inconsistencies in reporting test accuracy preclude making an informed judgment on the value of PET for this potential indication. Authors: Kamal Patel, Nira Hadar, Jounghee Lee, Barry A. [...]

Oral Cancer Foundation News Team - A2013-09-04T07:09:32-07:00September, 2013|Oral Cancer News|