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Treatment response in the neck: p16+ versus p16− oropharyngeal cancer
Author(s) -
Mak Daisy,
Hicks Rodney J,
Rischin Danny,
Solomon Ben,
Peters Lester,
Bressel Mathias,
Young Richard J,
Corry June
Publication year - 2013
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/1754-9485.12024
Subject(s) - medicine , nodal , positron emission tomography , chemoradiotherapy , nuclear medicine , stage (stratigraphy) , head and neck cancer , cancer , standardized uptake value , radiology , oncology , paleontology , biology
Abstract Introduction To compare nodal response rates following chemoradiotherapy in patients with p16+ and p16− oropharyngeal squamous cell carcinoma ( OPSCC ). Methods Patients with node‐positive OPSCC treated at P eter M ac C allum C ancer C entre on the published phase I–III tirapazamine trials were identified. All patients had conventional assessment (clinical examination ( CA ), CT and/or MRI ) and positron emission tomography ( PET ) at both baseline and 2–4 months post‐treatment. Results There were 30 p16+ and 18 p16− patients, the former group having significantly higher stage nodal disease ( P = 0.016). The mean overall reduction in nodal size at post‐treatment assessment was similar in p16+ and p16− patients (78% vs. 75%), and no statistically significant difference in nodal complete response ( CR ) rates was detected by either CA (50% vs. 39%, P = 0.35) or PET / PET ‐ CT (93% vs. 83%, P = 0.19). PET was significantly more accurate in determining the true nodal CR rate in both groups, with a negative predictive value of 96%. Conclusion Nodal response rates following chemoradiotherapy appear to be similar in p16+ and p16− patients when assessed by either CA or PET / PET ‐ CT . However, higher nodal CR was seen in PET / PET ‐ CT compared with CA in both groups. Metabolic imaging is more accurate than CA in assessing nodal response post‐treatment.