Faculty Collaboration Database

Clinical outcomes of patients receiving integrated PET/CT-guided radiotherapy for head and neck carcinoma. Int J Radiat Oncol Biol Phys 2008 Mar 01;70(3):678-84

Date

02/12/2008

Pubmed ID

18262086

DOI

10.1016/j.ijrobp.2007.10.044

Scopus ID

2-s2.0-38849083351 (requires institutional sign-in at Scopus site)   81 Citations

Abstract

PURPOSE: We previously reported the advantages of (18)F-fluorodeoxyglucose-positron emission tomography (PET) fused with CT for radiotherapy planning over CT alone in head and neck carcinoma (HNC). The purpose of this study was to evaluate clinical outcomes and the predictive value of PET for patients receiving PET/CT-guided definitive radiotherapy with or without chemotherapy.

METHODS AND MATERIALS: From December 2002 to August 2006, 42 patients received PET/CT imaging as part of staging and radiotherapy planning. Clinical outcomes including locoregional recurrence, distant metastasis, death, and treatment-related toxicities were collected retrospectively and analyzed for disease-free and overall survival and cumulative incidence of recurrence.

RESULTS: Median follow-up from initiation of treatment was 32 months. Overall survival and disease-free survival were 82.8% and 71.0%, respectively, at 2 years, and 74.1% and 66.9% at 3 years. Of the 42 patients, seven recurrences were identified (three LR, one DM, three both LR and DM). Mean time to recurrence was 9.4 months. Cumulative risk of recurrence was 18.7%. The maximum standard uptake volume (SUV) of primary tumor, adenopathy, or both on PET did not correlate with recurrence, with mean values of 12.0 for treatment failures vs. 11.7 for all patients. Toxicities identified in those patients receiving intensity modulated radiation therapy were also evaluated.

CONCLUSIONS: A high level of disease control combined with favorable toxicity profiles was achieved in a cohort of HNC patients receiving PET/CT fusion guided radiotherapy plus/minus chemotherapy. Maximum SUV of primary tumor and/or adenopathy was not predictive of risk of disease recurrence.

Author List

Vernon MR, Maheshwari M, Schultz CJ, Michel MA, Wong SJ, Campbell BH, Massey BL, Wilson JF, Wang D

Authors

Bruce H. Campbell MD Emeritus Professor in the Otolaryngology department at Medical College of Wisconsin
Mohit Maheshwari MD Professor in the Radiology department at Medical College of Wisconsin
Becky Massey MD Associate Professor in the Otolaryngology department at Medical College of Wisconsin
Michelle A. Michel MD Adjunct Professor in the Radiology department at Medical College of Wisconsin
Christopher J. Schultz MD Chair, Professor in the Radiation Oncology department at Medical College of Wisconsin
Stuart J. Wong MD Center Director, Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Carcinoma, Squamous Cell
Female
Fluorodeoxyglucose F18
Follow-Up Studies
Head and Neck Neoplasms
Humans
Male
Middle Aged
Neoplasm Recurrence, Local
Positron-Emission Tomography
Radiopharmaceuticals
Radiotherapy Planning, Computer-Assisted
Time Factors
Tomography, X-Ray Computed