PET-CT: A Useful Tool In Predicting Response To Treatment Of Head And Neck Cancer
A potent blend of imaging techniques performed 6-8 weeks subsequent to the patient completing chemoradiotherapy for head and neck cancer could be beneficial in identifying patients that have responded to treatment and those that would need follow-up for surgery.
In the previous two decades, chemoradiotherapy – merging chemotherapy and radiotherapy treatments – have turned increasingly significant in aiding organ preservation during head and neck cancer treatment, according to the background data present in the report appearing in the November edition of Archives of Otolaryngology- Head & Neck Surgery – one of the JAMA journals.
The authors have written that such non-operative strategies have given favourable outcomes at the primary tumor location and cervical lymph nodes leading to increased rates of locoregional disease control. Correct and prompt evaluation of disease response at the primary tumor location and cervical lymph nodes subsequent to chemotherapy is vital for detecting lingering disease, for directing surgical recovery and for averting tumor relapse.
James P. Malone, M.D., from the Southern Illinious School of Medicine, Springfield and associates evaluated thirty-one patients having advanced head and neck cancer staging that underwent treatment with chemoradiotherapy in the time periods from 2004-2006. All the patients were given positron emission tomography (PET) and computed tomography (PET-CT) in unison for detecting indication of continual tumors 6-8 weeks subsequent to conclusion of treatment and then were followed up for a median or midpoint of 2 years.
Evaluating tumor response to PET-CT treatment revealed a sensitivity or rate of true positives at 85%, specificity or rate of true negatives was detected at 54%, positive predictive value (possibility of patients testing affirmative for the disease presence) at 31% and negative predictive value (possibility of patients testing negative didn’t have the disease) at 92%.
Among 21 patients (about 78%) whose disease had metastasized to adjacent lymph nodes prior to treatment, sensitivity was observed at 78%; specificity was observed at greater than 94%; positive predictive value was found at greater than 75%, and negative predictive value was 94%. In 10 patients or 32% of the patients that had localised cancer in the neck, specificity was noted at 92% and negative predictive value was greater than 92%.
Based on the outcome of the study, PET-CT conducted 6-8 weeks subsequent to the conclusion of intra-arterial chemoradiotherapy in the case of advanced squamous cell carcinoma affecting the head and the neck is a beneficial tool in measurement of treatment response and facilitates in finalising clinical decisions. Alongside early forecast of remote metastases, it allows earlier intercession of PET-CT in consistently treated patient populaces with regular timing of post-treatment examinations are necessary to more evidently expound the role of this imaging modality in managing advanced squamous cell carcinoma of the head and the neck.
