Postoperative PET/CT and target delineation before adjuvant radiotherapy in patients with oral cavity squamous cell carcinoma

Head Neck. 2016 Apr;38 Suppl 1(Suppl 1):E1285-93. doi: 10.1002/hed.24213. Epub 2015 Sep 3.

Abstract

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.

Keywords: adjuvant radiation; oral cavity; postoperative; squamous cell carcinoma; surgery.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / diagnostic imaging*
  • Carcinoma, Squamous Cell / radiotherapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mouth Neoplasms / diagnostic imaging*
  • Mouth Neoplasms / radiotherapy*
  • Positron Emission Tomography Computed Tomography*
  • Positron-Emission Tomography
  • Radiotherapy, Adjuvant*
  • Retrospective Studies
  • Tomography, X-Ray Computed