Routine use of positron emission tomography/computed tomography (PET/CT) scans in head and neck cancer patient follow-up can detect local recurrences before they become clinically apparent and may improve the outcome of subsequent salvage therapy, according to a study presented at the Multidisciplinary Head and Neck Cancer Symposium, held from January 26-28, 2012 in the Biltmore, Phoenix, Arizona.

Extracranial head-and-neck carcinomas constitute of less than 6% of all cancers globally and approximately 2% to 3% in the United States. Each year head and neck cancer affects approximately 30,000 to 50,000 Americans and is considered a major public health problem.

The majority of head and neck cancers are squamous-cell carcinomas and in spite of several diagnostic advances, a vast majority of these are still diagnosed in advanced stages. Early detection followed by accurate staging is essential for proper treatment and prognosis. Following therapy, timely detection of recurrence is critical to achieve an optimal outcome as well as to plan salvage therapy. This is especially important because recurrent disease and metastatic spread to distant sites is usually unresponsive to therapy.

Relatively new
PET scan is a relatively new test and its use as a routine follow up for head and neck cancer patients is controversial. Most head and neck cancer follow-up studies use Fluorodeoxyglucose-PET (FDG-PET) scans when recurrence is suspected, but few studies have been conducted to determine the value of PET scans in fixed intervals post-treatment.

Post-therapy PET/CT
Researchers in this study reviewed 234 head and neck cancer cases treated with chemoradiation between 2006 and 2010 that also had a post-therapy PET/CT scan. The scans identified 15 patients with abnormalities requiring further evaluation, and biopsies showed malignancies in eight of the 15 cases. The other seven cases were false positives.

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Valuable as routine follow-up
All of the patients who had negative PET/CT scans remained disease free in subsequent follow-ups. ?With malignancies found in 53% of abnormal scans in this study, our research proves that PET/CT scans are valuable as routine follow-up and as a surveillance method for head and neck cancer patients,? Yasir Rudha, MD, MBChB, lead author of the study and a researcher at St. John Hospital/Van Elslander Cancer Center in Grosse Pointe Woods, Mich., said. ?However, since the rate of false positives was 46 percent, caution should be shown when ordering biopsies after abnormal scans to prevent excessive unnecessary biopsies.?

For more information:
– Rudha Y, Aref A, Chuba P, O’Brien K. The Value of PET Scan In The Routine Follow up of Patients With Squamous Cell Carcinoma of The Head and Neck. Multidisiplinary Head and Neck Cancer Symposium; January 26-28, 2012 Arizona Biltmore Phoenix. Abstract #226
– The Value of PET Scan in the Routine Follow-up of Patients with Squamous Cell Carcinoma of the Head and Neck (Slides)

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