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Temporal patterns of head and neck squamous cell carcinoma recurrence with positron‐emission tomography/computed tomography monitoring
Author(s) -
Beswick Daniel M.,
Gooding William E.,
Johnson Jonas T.,
Branstetter Barton F.
Publication year - 2012
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.23341
Subject(s) - medicine , asymptomatic , positron emission tomography , head and neck squamous cell carcinoma , radiology , confidence interval , retrospective cohort study , head and neck cancer , radiation therapy , surgery
Abstract Objectives/Hypothesis: To estimate the distribution of head and neck squamous cell carcinoma (HNSCC) recurrence after definitive chemoradiation therapy (CRT) among patients who underwent 18F‐fluorodeoxyglucose positron‐emission tomography and computed tomography (PET/CT) surveillance. Study Design: Retrospective review. Methods: HNSCC patients who underwent definitive CRT from 2001 to 2008 were evaluated for recurrence with serial PET/CT. Patients were excluded if they were previously treated for recurrent disease, were treated with surgery as the primary therapeutic modality, or had inadequate clinical follow‐up. Recurrence was defined by histopathologic evidence of tumor. Results: Three hundred eighty‐eight patients were studied. Patients in whom recurrence was not detected were followed clinically and radiographically for a median of 27 months. Tumor recurrence was detected in 110 patients. For 37 patients, recurrence was heralded by clinical signs. Among the 73 asymptomatic patients who had a confirmed recurrence, disease was detected by PET/CT between 2 and 43 months, median of 6 months. Forty‐five percent of observed asymptomatic recurrences were detected during the first 6 months of surveillance (95% confidence interval [CI], 34%‐57%), 79% within the first 12 months (95% CI, 68%‐88%), 95% within the first 24 months (95% CI, 87%‐98%), and 100% within the first 48 months (95% CI, 95%‐100%). Conclusions: Among HNSCC patients followed with PET/CT surveillance, 95% of observed asymptomatic recurrences were detected within 24 months after completing CRT. For patients without clinical signs of recurrence, routine PET/CT surveillance beyond the first 24 months may be of limited value and may not be cost effective. Laryngoscope, 2012