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PET/CT Planning Beneficial for Head and Neck Cancer Patients

by Barbara Kram, Editor | March 05, 2008
PET/CT provides
a higher level
of confidence.
Fairfax, Va. - Using a combination of positron emission tomography (PET) and computed tomography for radiation therapy treatment planning in head and neck carcinoma patients provides for excellent, local and regional disease control when compared to CT alone, according to a study in the March 1 issue of the International Journal for Radiation Oncology*Biology*Physics, the official journal of the American Society for Therapeutic Radiology and Oncology.

CT has been the traditional choice for staging and radiation therapy treatment planning for head and neck squamous cell carcinomas, which account for approximately 5 percent of malignancies worldwide; but PET has been shown to have advantages over CT and other imaging modalities in detecting primary tumors, involved lymph nodes and distant metastatic disease not clearly otherwise identified. PET alone does have several disadvantages though, such as poor correlation to precise anatomic structures, but these negative
impacts are significantly reduced when PET and CT are combined by fusing the separate scans taken on a hybrid scanner.

While it has been proven in several studies that PET/CT imaging is feasible for head and neck radiation therapy planning, very few studies have been done to determine the clinical outcomes. So, researchers in the departments of Radiation Oncology, Radiology, Neoplastic and Related Disorders, and Otolaryngology at the Medical College of Wisconsin in Milwaukee conducted this study to evaluate the clinical outcomes, including overall survival, disease-free survival and the incidence of recurrence of patients receiving PET/CT-guided radiation therapy and the correlation of the clinical outcomes to the maximum standard uptake value obtained on the PET scan.

Between December 2002 and August 2006, 42 patients with a median age of 55, who were diagnosed with head and neck squamous cell carcinoma, were given PET/CT imaging as part of their radiation therapy planning. All patients were observed for at least six months following their treatment, with a mean follow-up time of 32 months. Overall survival of the 42 study patients was 82.8 percent at two years and 74.1 percent at three years, superior to the survival rate that was found in a Radiation Therapy Oncology Group study in which patients
received standard fractionation or accelerated fractionation with concomitant boost. That study was the largest randomized trial of radiation therapy in locally advanced head and neck cancer.