Utility of positron emission tomography for the detection of disease in residual neck nodes after (chemo)radiotherapy in head and neck cancer.
BACKGROUND
This study evaluates the utility of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET) in patients with a node-positive mucosal head and neck squamous cell carcinoma who achieved a complete response at the primary site but had a residual mass in the neck 8 weeks or more after definitive (chemo)radiotherapy.


METHODS
Between October 1996 and July 2002, 39 eligible patients were identified. The reference PET scan was performed at a median of 12 weeks (range, 8-32 weeks) after treatment.


RESULTS
PET showed no metabolic activity in the residual mass in 32 patients. Five of these patients had a neck dissection and were all pathologically negative. The remaining 27 patients were observed for a median of 34 months (range, 16-86 months), with only one locoregional failure. The negative predictive value of PET for viable disease in a residual anatomic abnormality was 97%.


CONCLUSIONS
Patients who have achieved a complete response at the primary site but have a residual abnormality in the neck that is PET negative approximately 12 weeks after treatment do not require neck dissection and can be safely observed. Head Neck
Porceddu
Sandro V
SV
Division of Radiation Oncology, St. Andrews Place, East Melbourne, Australia. sandro_porceddu@health.qld.gov.au
Jarmolowski
Elizabeth
E
Hicks
Rodney J
RJ
Ware
Rob
R
Weih
LeAnn
L
Rischin
Danny
D
Corry
June
J
Peters
Lester J
LJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D011879:Radiotherapy Dosage
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18