Study: PET/CT could predict response to neck and head cancer treatment

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The use of PET/CT after a patient completes chemoradiotherapy for head and neck cancer could help identify whether that patient will respond to treatment or will require surgical follow-up, according to a study in the November issue of Archives of Otolaryngology–Head & Neck Surgery.

James P. Malone, MD, and colleagues from the Southern Illinois School of Medicine, Springfield, studied 31 patients with advanced-stage neck cancer who were treated with chemoradiotherapy between  2004 and 2006. Six to eight weeks after the completion of the treatment all of the patients underwent combined PET/CT imaging to detect persistent tumors. The patients were traced for median period of 24 months.

The use of PET/CT in assessing the response of these tumors to treatment had a sensitivity, specificity, positive predictive value and negative predictive value of 83 percent, 54 percent, 31 percent and 92 percent respectively.  In the 21 patients whose disease spread to surrounding lymph nodes before treatment, sensitivity, specificity, positive predictive value and negative predictive value was 75 percent, 94 percent, 75 percent and 94 percent respectively.

“On the basis of this study, PET/CT performed six to eight weeks after the completion of intra-arterial chemoradiotherapy for advanced squamous cell carcinoma of the head and neck is a valuable tool for measuring treatment response and facilitating clinical decision making,” the authors stated. “In addition to early prediction of treatment response, PET/CT provides early detection of distant metastases, which permits earlier intervention in patients with distant disease. Further investigations of PET/CT in homogenously treated patient populations with consistent timing of post-treatment scans are necessary to more clearly elucidate the role of this imaging modality in the management of advanced squamous cell carcinoma of the head and neck.”