title: Impact of initial FDG PET/CT in the management plan of patients with locally advanced head and neck cancer.
abstract: OBJECTIVE
  To determine the impact of initial FDG PET/CT staging on clinical stage and the management plan in patients with locally advanced head and neck cancer (LAHNC).
  
  
  METHODS
  We retrospectively reviewed the records of 72 consecutive patients (2007-2010) staged with PET/CT and conventional CT with tumours of hypopharynx/larynx (26 patients, 36 %), oral cavity (17 patients, 24 %), oropharynx (16 patients, 22 %), nasopharynx (12 patients, 17 %), and others (2 %). The impact of PET/CT on management plans was considered high when PET/CT changed the planned treatment modality or treatment intent, and intramodality changes were considered as minor changes with low impact.
  
  
  RESULTS
  FDG PET/CT changed the stage in 27 patients and had high impact on the management plan in 12 % of patients (detection of distant metastases in 6 patients and stage II in 2 patients). Intramodality changes were more frequent: FDG PET/CT altered the TNM stage in 18/72 (25 %) of patients, upstaging N stage in 90 % of patients with low impact.
  
  
  CONCLUSIONS
  Initial FDG PET/CT staging not only improves stage but also affects the management plan in LAHNC patients.
authors: Service of Radiation Oncology, Complejo Hospitalario de Navarra, 3, Irunlarrea, 31008, Pamplona, Navarra, Spain, farias.delavega@outlook.es.
authors: F
authors: F
authors: Arias
authors: V
authors: V
authors: Chicata
authors: M J
authors: MJ
authors: García-Velloso
authors: G
authors: G
authors: Asín
authors: M
authors: M
authors: Uzcanga
authors: C
authors: C
authors: Eito
authors: I
authors: I
authors: Quilez
authors: A
authors: A
authors: Viudez
authors: J
authors: J
authors: Saenz
authors: I
authors: I
authors: Hernández
authors: C
authors: C
authors: Caicedo
authors: M
authors: M
authors: Errasti
authors: M
authors: M
authors: Barrado
authors: F
authors: F
authors: García-Bragado
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000556:secondary*; D019468:Disease Management; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18