Positron Emission Tomography With [18F]Fluorodeoxyglucose Improves Staging and Patient Management in Patients With Head and Neck Squamous Cell Carcinoma: A Multicenter Prospective Study
Positron Emission Tomography With [18F]Fluorodeoxyglucose Improves Staging and Patient Management in Patients With Head and Neck Squamous Cell Carcinoma: A Multicenter Prospective Study
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DOI：
10.1200/jco.2009.24.6298
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发表时间：
2010-03-01
影响因子：
45.3
通讯作者：
Gregoire, Vincent
中科院分区：
文献类型：
--
作者：
Lonneux, Max;Hamoir, Marc;Gregoire, Vincent
PurposeTo address的影响，正电子发射断层扫描与[F-18]氟脱氧葡萄糖（PET-FDG）的初步分期和管理的患者与头颈部鳞状细胞癌（HNSCChistoryandMethodsThis多中心，前瞻性研究包括233例新诊断和未经治疗的HNSCC。首先根据常规检查（包括体格检查、头颈部计算机断层扫描[CT]/磁共振成像和胸部CT）确定TNM分期和治疗决定，并密封在信封1中。然后进行全身PET-FDG，并将随后的TNM分期和治疗决定写在信封2中。记录PET-FDG显像后TNM分期和患者管理的变化。临床结果和组织病理学被用作金标准来验证TNM分期。常规和PET阶段进行了比较，使用McNemar test.ResultsConventional和PET阶段是不一致的100（43%）的233例患者。PET在47例患者中被证明是准确的，在13例患者中不准确。40例患者的TNM状态未得到确认，因为预计分期差异不会导致治疗改变。常规+ PET TNM分类（信封2）比常规分类（信封1; P <0.0001，McNemar检验）更准确。PET-FDG改变了32（13.7%）的233 patients.Conclusionadding全身PET-FDG治疗前的常规分期HNSCC改善了TNM分期的疾病，并改变了13.7%的患者的管理计划。这些发现支持PET-FDG在HNSCC常规成像检查中的应用。J Clin Oncol 28：1190-1195. (C)2010年美国临床肿瘤学会
PurposeTo address the impact of positron emission tomography with [F-18] fluorodeoxyglucose (PET-FDG) on the initial staging and management of patients with head and neck squamous cell carcinoma (HNSCC).Patients and MethodsThis multicenter, prospective study included 233 patients with newly diagnosed and untreated HNSCC. TNM stage and therapeutic decision were first determined based on the conventional work- up (including physical examination, computed tomography [CT]/magnetic resonance imaging of the head and neck region, and thoracic CT) and sealed in envelope 1. Whole- body PET-FDG was then performed, and subsequent TNM stage and therapeutic decision were written in envelope 2. Changes in TNM stages and in patient management as a result of PET- FDG imaging were recorded. Clinical outcome and histopathology were used as gold standards to validate the TNM stage. Conventional and PET stages were compared using the McNemar test.ResultsConventional and PET stage were discordant in 100 (43%) of 233 patients. PET proved to be accurate in 47 patients and inaccurate in 13 patients. TNM status was left unconfirmed in 40 patients because no therapeutic change was expected from the stage difference. Conventional + PET TNM classification (envelope 2) was significantly more accurate than conventional classification (envelope 1; P < .0001, McNemar test). PET-FDG altered the therapeutic plan in 32 (13.7%) of 233 patients.ConclusionAdding whole-body PET-FDG to the pretherapeutic conventional staging of HNSCC improved the TNM classification of the disease and altered the management of 13.7% of patients. These findings support the implementation of PET-FDG in the routine imaging work-up of HNSCC. J Clin Oncol 28: 1190-1195. (C) 2010 by American Society of Clinical Oncology