title: The Impact of (18)F-FDG PET CT Prior to Chemoradiotherapy for Stage III/IV Head and Neck Squamous Cell Carcinoma.
abstract: Introduction. To determine the value of a FDG-PET-CT scan in patients with locally advanced head and neck squamous cell carcinoma (HNSCC) prior to chemoradiotherapy. Materials and Methods. Consecutive patients with stage III or IV HNSCC who had undergone a staging FDG-PET-CT scan prior to chemoradiotherapy between August 2008 and April 2011 were included. Clinical details and conventional imaging (CT and/or MRI) were, retrospectively, reviewed, a TNM stage was assigned, and levels of cervical lymph node involvement were documented. This process was repeated with the addition of FDG-PET-CT. Radiotherapy plans were reviewed for patients with an alteration identified on TNM staging and/or nodal level identification with FDG-PET-CT and potential alterations in radiotherapy planning were documented. Results. 55 patients were included in the analysis. FDG-PET-CT altered the TNM stage in 17/55 (31%) of patients, upstaging disease in 11 (20%) and downstaging in 6 (11%); distant metastases were identified by FDG-PET-CT in 1 (2%) patient. FDG-PET-CT altered the lymph node levels identified in 22 patients (40%), upclassifying disease in 16 (29%) and downclassifying in 6 (11%). Radiotherapy plans were judged retrospectively to have been altered by FDG-PET-CT in 10 patients (18%). Conclusions. The use of FDG-PET-CT potentially impacts upon both treatment decisions and radiotherapy planning.
authors.affiliation: Departments of Nuclear Medicine, St. James's Institute of Oncology, Leeds LS9 7TF, UK.
authors.forename: Robin J D
authors.initials: RJ
authors.lastname: Prestwich
authors.forename: Priya
authors.initials: P
authors.lastname: Bhatnagar
authors.forename: Fahmid U
authors.initials: FU
authors.lastname: Chowdhury
authors.forename: Chirag N
authors.initials: CN
authors.lastname: Patel
authors.forename: Karen E
authors.initials: KE
authors.lastname: Dyker
authors.forename: Catherine
authors.initials: C
authors.lastname: Coyle
authors.forename: Mehmet
authors.initials: M
authors.lastname: Sen
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Scarsbrook