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J Nucl Med. 2008; 49 (Supplement 1):115P
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Oncology-Clinical Diagnosis: Solid Tumors

Head and Neck Cancer

PET-FDG affects staging and patient management in head and neck cancer. A multi-center prospective study

Max Lonneux1, Marc Hamoir2, Philippe Maingon5, Christian Duvillard7, Gilles Calais4, Boumediene Bridji8, Laurence Digue6, Michel Toubeau9 and Vincent Gregoire3

1 Nuclear Medicine; 2 H&N Surgery; 3 Radiation Oncology, UCL, Brussels, Belgium; 4 Radiation Oncology, CHU-Tours, Tours, France; 5 Radiation Oncology, CLCC GF-Leclerc, Dijon, France; 6 Radiation Oncology, H. Timone, Marseille, France; 7 H&N Surgery, CHU-Dijon, Dijon, France; 8 Nuclear Medicine, Centre R Gauducheau, Nantes, France; 9 Nuclear Medicine, CLCC GF-Leclerc, Dijon, France

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Objectives: To study the impact of staging FDG-PET on the management of H&N cancer patients.

Methods: 248 pts with histologically proven HNSCC were included in a multi-centric prospective study (oral cavity :75, oropharynx : 76, hypopharynx :48, larynx :44, UPT :3, other :2). Conventional staging included CT-MR-US and endoscopy. Stage+therapeutic decision was recorded into Enveloppe 1. Stage+therapeutic decision resulting from conventional staging + PET was recorded in Enveloppe 2. Data of 233 pts were analyzed. Env1 and Env2 were compared in terms of stage change : upstaging, downstaging, no change. Impact on patient management was categorized into «none» (PET data ignored), «low» (no treatment change), «medium» (change in planned procedure), and «high» (change in treatment modality, e.g. curative to palliative).

Results: TNM stage of Env1 and Env2 were discordant in 99 pts (42.5%). PET stage was correct in 46/99 pts (upstaging in 29, downstaging in 17), and incorrect in 13 pts. The status remained « unconfirmed » in 40 pts. PET detected metastases in 13 pts with M0 stage in Env1. PET was found to accurately modify the stage of the disease in 19.8% of the patients (46/233pts). Significant change in patient management (MEDIUM+HIGH) was observed in 30/233 pts (12.8%).

Conclusions: PET-FDG improves the pretherapeutic TNM stage in 19.8% of patients with HNSCC. Improved staging results in change in therapeutic management of 12.8% of patients.





This Article
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Right arrow Alert me to new issues of the journal
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Google Scholar
Right arrow Articles by Lonneux, M.
Right arrow Articles by Gregoire, V.
PubMed
Right arrow Articles by Lonneux, M.
Right arrow Articles by Gregoire, V.