4.3 Article

Modification of staging and treatment of head and neck cancer by FDG-PET/CT prior to radiotherapy

Journal

STRAHLENTHERAPIE UND ONKOLOGIE
Volume 189, Issue 3, Pages 197-201

Publisher

SPRINGER HEIDELBERG
DOI: 10.1007/s00066-012-0283-0

Keywords

FDG - PET/CT; Radiotherapy planning; Head and neck neoplasms; Therapy intention; Planning techniques

Funding

  1. German Federal Ministry of Education and Research, Germany
  2. ERDF European Regional Development Fund [100066308]
  3. BMBF [03ZIK042]

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Reliable tumor staging is a fundamental pre-requisite for efficient tumor therapy and further prognosis. The aim of this study was to compare head and neck cancer (HNC) staging before and after FDG-PET/CT, evaluating the stage modifications for radiotherapy (RT) planning. A total of 102 patients with untreated primary HNC, who underwent conventional staging and staging including FDG-PET/CT before RT, were enrolled in this retrospective study. Blinded pre-FDG-PET/CT and post-FDG-PET/CT staging data were compared. The impact on patient management was tested by comparing the intention before and after FDG-PET/CT. Significant modifications of T, N, and M stage as well as clinical stage were detected after inclusion of FDG-PET/CT data (p = 0.002, 0.0006, 0.001, 0.03, respectively). Overall, the implementation of FDG-PET/CT led to modification of RT intention decision in 14 patients. FDG-PET/CT demonstrates essential influence on tumor staging in HNC patients scheduled for irradiation. Implementation of FDG-PET/CT in imaging protocol improves selection of candidates for curative and palliative RT and allows further optimization of treatment management and therapy intention.

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