Postoperative PET/CT and target delineation before adjuvant radiotherapy in patients with oral cavity squamous cell carcinoma.
Pinaki R Dutta, Nadeem Riaz, Sean McBride, Luc G Morris, Snehal Patel, Ian Ganly, Richard J Wong, Frank Palmer, Heiko Schöder, Nancy Lee
Author Information
- Pinaki R Dutta: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
- Nadeem Riaz: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
- Sean McBride: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
- Luc G Morris: Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
- Snehal Patel: Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
- Ian Ganly: Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
- Richard J Wong: Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
- Frank Palmer: Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
- Heiko Schöder: Department of Nuclear Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
- Nancy Lee: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
BACKGROUND: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSION: 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.
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- K08 DE024774/NIDCR NIH HHS
- P30 CA008748/NCI NIH HHS
Adult
Aged
Aged, 80 and over
Carcinoma, Squamous Cell
Female
Humans
Male
Middle Aged
Mouth Neoplasms
Positron Emission Tomography Computed Tomography
Positron-Emission Tomography
Radiotherapy, Adjuvant
Retrospective Studies
Tomography, X-Ray Computed
