Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2007
Impact of FDG-PET to detect recurrence of head and neck squamous cell carcinoma.
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Périé Sophie, Hugentobler Alexis, Susini Bertrand, Balogova Sona, Grahek Dany, Kerrou Khaldoun, Montravers Françoise, Chater Pierre El, St Guily Jean Lacau, Talbot Jean-Noël
Аннотация
OBJECTIVE: Prospectively evaluate the impact of fluorodeoxyglucose-fluorine-18 positron emission tomography (FDG-PET) in the management of recurrence of advanced head and neck squamous cell carcinoma during the first year after treatment.
STUDY DESIGN: Seventy patients were followed-up every 6 to 8 weeks during the first year after initial combined curative therapy. FDG-PET, together with conventional imaging and endoscopy were performed systematically at 1 year (group A) or prompted earlier in case of clinically suspicious recurrence (group B). The referring physician evaluated the impact of FDG-PET on the patient's management. Another clinician checked the pertinence of decisions.
RESULTS: FDG-PET had a therapeutic impact in 8 of 43 group A patients and in 16 of 27 group B patients; the overall rate was 34%. This change was pertinent in 5 of 8 and 14 of 16 cases, respectively. Overall pertinence rate of decisions was 90% versus 70% without FDG-PET.
CONCLUSIONS: FDG-PET had a significant overall therapeutic impact; the induced decisions were either pertinent or just led to "futile" noninvasive examinations. Systematic FDG-PET had a significantly lesser impact in comparison with FDG-PET motivated by clinical suspicion.
STUDY DESIGN: Seventy patients were followed-up every 6 to 8 weeks during the first year after initial combined curative therapy. FDG-PET, together with conventional imaging and endoscopy were performed systematically at 1 year (group A) or prompted earlier in case of clinically suspicious recurrence (group B). The referring physician evaluated the impact of FDG-PET on the patient's management. Another clinician checked the pertinence of decisions.
RESULTS: FDG-PET had a therapeutic impact in 8 of 43 group A patients and in 16 of 27 group B patients; the overall rate was 34%. This change was pertinent in 5 of 8 and 14 of 16 cases, respectively. Overall pertinence rate of decisions was 90% versus 70% without FDG-PET.
CONCLUSIONS: FDG-PET had a significant overall therapeutic impact; the induced decisions were either pertinent or just led to "futile" noninvasive examinations. Systematic FDG-PET had a significantly lesser impact in comparison with FDG-PET motivated by clinical suspicion.
Предметные рубрики MeSH
AdultAgedCarcinoma, Squamous CellDecision MakingEndoscopyFemaleFluorodeoxyglucose F18Follow-Up StudiesHead and Neck NeoplasmsHumansHypopharyngeal NeoplasmsLaryngeal NeoplasmsLymphatic MetastasisMaleMiddle AgedNeoadjuvant TherapyNeoplasm Recurrence, LocalOropharyngeal NeoplasmsPositron-Emission TomographyProspective StudiesRadiopharmaceuticalsTomography, X-Ray ComputedTreatment Outcome