| Early prediction of response to chemoradiotherapy for head and neck cancer: reliability of restaging with combined positron emission tomography and computed tomography. | |
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MedLine Citation:
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PMID: 19917925 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To assess the role of combined positron emission tomography and computed tomography (PET-CT) in predicting early treatment response at the primary site and in the neck after chemoradiotherapy (CRT) for advanced squamous cell carcinoma of the head and neck (SCCHN). DESIGN: Retrospective analysis with a median follow-up of 24 months. SETTING: Academic, tertiary referral center. PATIENTS AND INTERVENTIONS: Thirty-one patients who were treated with concomitant intra-arterial CRT underwent PET-CT 6 to 8 weeks after the completion of treatment. Patients with findings on the physical examination, CT, or PET-CT indicative of persistent disease underwent appropriate surgical intervention for pathological assessment. Patients with a complete clinical response were observed with routine follow-up physical examination for disease recurrence. No evidence of disease at least 6 months after the completion of PET-CT was considered confirmation of complete clinical response. MAIN OUTCOME MEASURES: Presence or absence of residual or recurrent disease during the follow-up period was used to calculate the sensitivity, specificity, and positive and negative predictive values of PET-CT for the primary site and the neck. RESULTS: Assessment of tumor response at the primary site with PET-CT had a sensitivity, specificity, and positive and negative predictive values of 83%, 54%, 31%, and 92%, respectively. In patients with pretreatment N1 to N3 disease, the sensitivity, specificity, and positive and negative predictive values of posttreatment PET-CT were 75%, more than 94%, more than 75%, and 94%, respectively, and the specificity and negative predictive value for patients with pretreatment N0 disease in the neck were 92% and more than 92%, respectively. CONCLUSIONS: Negative PET-CT findings accurately determine early disease response at the primary site and in the neck. False-positive findings are common at the primary site. Patients with a negative PET-CT finding after the completion of intra-arterial CRT do not require surgical intervention. |
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Authors:
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James P Malone; Michael A T Gerberi; Syam Vasireddy; Larry F Hughes; Krishna Rao; Bruce Shevlin; Matthew Kuhn; Dean Collette; Joel Tennenhouse; K Thomas Robbins |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Archives of otolaryngology--head & neck surgery Volume: 135 ISSN: 1538-361X ISO Abbreviation: Arch. Otolaryngol. Head Neck Surg. Publication Date: 2009 Nov |
Date Detail:
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Created Date: 2009-11-17 Completed Date: 2009-12-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8603209 Medline TA: Arch Otolaryngol Head Neck Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1119-25 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgery, Southern Illinois School of Medicine, Springfield, IL 62794-9649, USA. jmalone@siumed.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Antineoplastic Agents
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therapeutic use* Carcinoma, Squamous Cell / diagnosis, drug therapy, radiotherapy* Female Follow-Up Studies Head and Neck Neoplasms / diagnosis, drug therapy, radiotherapy* Humans Male Neoplasm Recurrence, Local / diagnosis* Neoplasm Staging / methods* Positron-Emission Tomography / methods* Prognosis Reproducibility of Results Retrospective Studies Time Factors Tomography, X-Ray Computed / methods* |
| Chemical | |
Reg. No./Substance:
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0/Antineoplastic Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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