Positron emission tomography in the early follow-up of advanced head and neck cancer
Positron emission tomography in the early follow-up of advanced head and neck cancer
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DOI：
10.1001/archotol.130.1.105
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发表时间：
2004-01-01
影响因子：
--
通讯作者：
Stoeckli, SJ
中科院分区：
文献类型：
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作者：
Goerres, GW;Schmid, DT;Stoeckli, SJ
目的：评价晚期头颈部鳞状细胞癌(HNSCC)患者在首次常规临床对照时进行早期正电子发射断层扫描(PET)检查的临床效果。设计：前瞻性、非随机、病例对照研究。设置：单一转诊中心。患者和干预：26例经组织学证实的III-IV期HNSCC患者(平均年龄56岁)在放化疗综合治疗结束前和治疗结束后约6周进行正电子发射断层扫描。主要观察指标：证实有远处转移、继发性同步癌和局部残留组织的存在，并评估其对进一步临床治疗的影响。结果：在10例患者中，我们通过PET正确地识别了残留肿瘤组织、远处转移或第二原发灶，其中5例没有临床证据。结果14例为真阴性，1例为假阳性，1例为假阴性。随访PET的敏感性和特异性分别为90.9%和93.3%。所有阳性患者均接受挽救手术等进一步治疗的评估。结论：放化疗联合治疗结束约6周后，全身PET扫描可以可靠地发现晚期HNSCC患者的局部区域残留癌和远处转移或继发肿瘤，并对治疗决策有直接影响。
Objective: To assess the clinical effect of an early follow-up positron emission tomography (PET) examination at the time of the first routine clinical control in patients with advanced-stage head and neck squamous cell carcinoma (HNSCC).Design: Prospective, nonrandomized, case-control study.Setting: Single referral center.Patients and Intervention: A total of 26 patients (mean age, 56 years) with histologically confirmed stage III-IV HNSCC underwent PET before and approximately 6 weeks after the end of a combined treatment with radiation and chemotherapy with curative intent. The PET findings were confirmed by histologic analysis and a 6-month clinical follow-up.Main Outcome Measures: The presence of distant metastases, secondary synchronous cancers, and residual locoregional tissue was confirmed, and the effect on further clinical management was assessed.Results: Using PET, we correctly identified residual tumor tissue, distant metastases, or a second primary tumor in 10 patients, 5 of whom had no clinical evidence of such findings. Results were true negative in 14 cases; false positive in 1; and false negative in 1. Sensitivity and specificity for follow-up PET scans were 90.9% and 93.3%, respectively. All patients with positive findings were evaluated for further treatment such as salvage surgery.Conclusions: Whole-body PET scanning approximately 6 weeks after completion of a combined treatment regimen with radiation and chemotherapy can reliably identify locoregional residual cancer and distant metastases or secondary tumors in patients with advanced-stage HNSCC and has a direct influence on management decisions.