Postoperative PET/CT and target delineation before adjuvant radiotherapy in patients with oral cavity squamous cell carcinoma.
The purpose of this study was for us to present our evaluation of the effectiveness of positron emission tomography (PET)/CT imaging in postoperative patients with oral cavity squamous cell carcinoma (SCC) before initiating adjuvant radiation therapy.



Treatment planning PET/CT scans were obtained in 44 patients with oral cavity SCC receiving adjuvant radiation. We identified target areas harboring macroscopic disease requiring higher radiation doses or additional surgery.



Fourteen PET/CT scans were abnormal. Thirteen patients underwent surgery and/or biopsy, increased radiation dose, and/or addition of chemotherapy. Eleven patients received higher radiation doses. Patients undergoing imaging >8 weeks were more likely to have abnormal results (p = .01). One-year distant metastases-free survival was significantly worse in patients with positive PET/CT scans (61.5% vs 92.7%; p = .01). The estimated positive predictive value (PPV) was 38% for postoperative PET/CT scanning.



We demonstrated that 32% of patients have abnormal PET/CT scans resulting in management changes. Patients may benefit from postoperative PET/CT imaging to optimize adjuvant radiation treatment planning. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1285-E1293, 2016.
Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
Pinaki R
PR
Dutta
Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
Nadeem
N
Riaz
Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
Sean
S
McBride
Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
Luc G
LG
Morris
Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
Snehal
S
Patel
Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
Ian
I
Ganly
Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
Richard J
RJ
Wong
Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
Frank
F
Palmer
Department of Nuclear Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
Heiko
H
Schöder
Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
Nancy
N
Lee
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D000072078:Positron Emission Tomography Computed Tomography; D049268:Positron-Emission Tomography; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
adjuvant radiation; oral cavity; postoperative; squamous cell carcinoma; surgery