Accuracy of positron emission tomography in the evaluation of patients treated with chemoradiotherapy for mucosal head and neck cancer.
BACKGROUND
The aim of this study was to evaluate the accuracy of positron emission tomography (PET) in assessing the patients treated with primary chemoradiotherapy for mucosal carcinoma of the head and neck.


METHODS
A retrospective review of patients with biopsy-proven cancer of mucosal head and neck sites receiving chemoradiotherapy with curative intent was undertaken.


RESULTS
Seventy-eight patients met the study criteria. Staging PET identified unsuspected distant metastatic disease in 11% of patients. Sixty-one patients (78%) had a complete metabolic response on PET, with 17 showing residual disease. Sensitivity of PET was 82% (positive predictive value: 82%) and specificity was 95% (negative predictive value: 95%). Accuracy of PET response was significantly better than clinical assessment and conventional imaging (p < .002, p < .001, respectively).


CONCLUSIONS
PET has been found to be significantly better than clinical examination or conventional imaging in restaging patients after chemoradiotherapy. Patients with a complete response on posttreatment PET have a significant survival advantage and can be safely observed.
Martin
Richard C W
RC
Sydney Head and Neck Cancer Institute, Sydney Cancer Centre, Royal Prince Alfred Hospital and University of Sydney, Sydney, Australia.
Fulham
Michael
M
Shannon
Kerwin F
KF
Hughes
Ceri
C
Gao
Kan
K
Milross
Chris
C
Tin
Mo Mo
MM
Jackson
Michael
M
Clifford
Anthony
A
Boyer
Michael J
MJ
O'Brien
Christopher J
CJ
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000532:radiotherapy; D015331:Cohort Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000532:radiotherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult