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PET, PET/CT, and Head and Neck Squamous Cell Carcinoma: Is it time to Review the NCCN Guidelines?
Author(s) -
Cheng Jeffrey,
Genden Eric M,
Chien Daniel,
Som Peter,
Kostakoglu Lale
Publication year - 2009
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.20284
Subject(s) - citation , head and neck , section (typography) , library science , presentation (obstetrics) , head and neck squamous cell carcinoma , basal cell , medicine , art history , computer science , art , cancer , pathology , head and neck cancer , surgery , operating system
Conclusion Patients presenting with earlier stage tumors have excellent cure rates. In addition, treatment of early recurrence may improve survival, as it may be more amenable to surgical salvage, re-irradiation, and/or chemotherapy. The National Comprehensive Cancer Network (NCCN) guidelines for the treatment of HNSCC do not include the use of PET/CT and/or specify how to radiographically monitor patients after treatment. PET clearly has demonstrated some advantages over conventional imaging with CT and MRI, and PET/CT is even more superior. PET and PET/CT have demonstrated an improved ability to detect tumor recurrence over conventional imaging modalities and probably should be integrated into HNSCC posttreatment surveillance protocols, because there is a survival benefit for salvage therapy in early over late recurrences. HNSCC Surveillance • Early recurrence in head and neck cancer may be asymptomatic in patients, and up to 61% of recurrences in head and neck cancer may be found by patients after self-referral for specific symptoms • de Visscher and Manni concluded that recurrent disease found during routine follow-up was associated with a mean survival that was twice as high as those patients’ whose recurrence was found by self-referral • A Dutch study by Ritoe et al showed a survival benefit for salvage therapy between patients with recurrent laryngeal carcinoma found on routine, as opposed to, non-routine followup