Back to Search
Start Over
Positive Clinical Impact of an Additional PET/CT Scan Before Adjuvant Radiotherapy or Concurrent Chemoradiotherapy in Patients with Advanced Oral Cavity Squamous Cell Carcinoma
- Source :
- Journal of Nuclear Medicine. 56:22-30
- Publication Year :
- 2014
- Publisher :
- Society of Nuclear Medicine, 2014.
-
Abstract
- The aim of this single-center study was to investigate whether obtaining an additional PET/CT scan before adjuvant radiotherapy or concurrent chemoradiotherapy (CCRT) could meaningfully improve 2-y disease-free survival (DFS) and disease-specific survival (DSS) rates.Six hundred seventy-four patients with oral cavity squamous cell carcinoma who received adjuvant therapy after radical surgery were included. Of these, 152 patients were initially scheduled to receive an additional preradiotherapy/CCRT PET/CT scan within 1 wk of starting adjuvant therapy. However, 16 patients were excluded because of either medical problems or refusal. Therefore, 136 patients underwent a preradiotherapy/CCRT PET/CT scan (PET group), and 522 did not (NO-PET group). All of the participants were followed up for at least 2 y or censored at the last follow-up. The impact of preradiotherapy/CCRT PET/CT imaging was examined using Kaplan-Meier curves and Cox proportional hazards models.Two-year DFS (80% vs. 70%, P = 0.033) and DSS (84% vs. 75%, P = 0.010) rates were significantly higher in the PET than in the NO-PET group. In the PET group, both DFS and DSS were higher in patients with negative findings than in those without (88% vs. 22% and 91% vs. 36%, respectively; both P0.001). A prognostic scoring system based on the presence of the 2 independent risk factors in the PET group (extracapsular spread and lymphatic invasion) predicted both DFS (P = 0.001 and P0.001, respectively) and DSS (P = 0.001 and P0.001, respectively). Nineteen patients (14%) had their treatment modified by preradiotherapy/CCRT PET/CT findings. Of these, 15 were treated with curative intent due to the presence of locoregional disease, and 4 received palliative care due to distant metastases. Seven of the 15 patients are currently alive without disease.An additional preradiotherapy/CCRT PET/CT scan improves both DFS and DSS in patients with advanced oral cavity squamous cell carcinoma.
- Subjects :
- Adult
Male
Palliative care
Lymphovascular invasion
Multimodal Imaging
Fluorodeoxyglucose F18
Risk Factors
Adjuvant therapy
Humans
Medicine
Radiology, Nuclear Medicine and imaging
In patient
Oral Cavity Squamous Cell Carcinoma
Radical surgery
PET-CT
Adjuvant radiotherapy
business.industry
Chemoradiotherapy
Prognosis
Treatment Outcome
Positron-Emission Tomography
Carcinoma, Squamous Cell
Female
Mouth Neoplasms
Radiotherapy, Adjuvant
Tomography, X-Ray Computed
Nuclear medicine
business
Subjects
Details
- ISSN :
- 2159662X and 01615505
- Volume :
- 56
- Database :
- OpenAIRE
- Journal :
- Journal of Nuclear Medicine
- Accession number :
- edsair.doi.dedup.....c11dceddee880c393b80a85e8dd40ba4