Modification of staging and treatment of head and neck cancer by FDG-PET/CT prior to radiotherapy.


Modification of staging and treatment of head and neck cancer by FDG-PET/CT prior to radiotherapy.

Abramyuk, A.; Appold, S.; Zöphel, K.; Baumann, M.; Abolmaali, N.

BACKGROUND AND PURPOSE:

Reliable tumor staging is a fundamental pre-requisite for efficient tumor therapy and further prognosis. The aim of this study was to compare head and neck cancer (HNC) staging before and after FDG-PET/CT, evaluating the stage modifications for radiotherapy (RT) planning.
PATIENTS AND METHODS:
A total of 102 patients with untreated primary HNC, who underwent conventional staging and staging including FDG-PET/CT before RT, were enrolled in this retrospective study. Blinded pre-FDG-PET/CT and post-FDG-PET/CT staging data were compared. The impact on patient management was tested by comparing the intention before and after FDG-PET/CT.
RESULTS:
Significant modifications of T, N, and M stage as well as clinical stage were detected after inclusion of FDG-PET/CT data (p = 0.002, 0.0006, 0.001, 0.03, respectively). Overall, the implementation of FDG-PET/CT led to modification of RT intention decision in 14 patients.
CONCLUSIONS:
FDG-PET/CT demonstrates essential influence on tumor staging in HNC patients scheduled for irradiation. Implementation of FDG-PET/CT in imaging protocol improves selection of candidates for curative and palliative RT and allows further optimization of treatment management and therapy intention.

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Publ.-Id: 19994