InterCommunity Cancer Centers, Leesburg, FL - PET/CT PLANNING BENEFICIAL FOR HEAD AND NECK CANCER PATIENTS

Combining Imaging Modalities Provides Excellent Clinical Outcomes

LEESBURG, FL – Using a combination of positron emission tomography (PET) and computed tomography for radiation therapy treatment planning in head and neck carcinoma patients provides for excellent, local and regional disease control when compared to CT alone, according to a study in the March 1 issue of the International Journal for Radiation Oncology Biology Physics, the official journal of the American Society for Therapeutic Radiology and Oncology.

CT has been the traditional choice for staging and radiation therapy treatment planning for head and neck squamous cell carcinomas, which account for approximately five percent of malignancies worldwide; but PET has been shown to have advantages over CT and other imaging modalities in detecting primary tumors, involved lymph nodes and distant metastatic disease not clearly otherwise identified. PET alone does have several disadvantages though, such as poor correlation to precise anatomic structures, but these negative impacts are significantly reduced when PET and CT are combined by fusing the separate scans taken on a hybrid scanner.

While it has been proven in several studies that PET/CT imaging is feasible for head and neck radiation therapy planning, very few studies have been done to determine the clinical outcomes. So, researchers in the departments of Radiation Oncology, Radiology, Neoplastic and Related Disorders, and Otolaryngology at the Medical College of Wisconsin in Milwaukee conducted this study to evaluate the clinical outcomes, including overall survival, disease-free survival and the incidence of recurrence of patients receiving PET/CT-guided radiation therapy and the correlation of the clinical outcomes to the maximum standard uptake value obtained on the PET scan.

Between December 2002 and August 2006, 42 patients with a median age of 55, who were diagnosed with head and neck squamous cell carcinoma, were given PET/CT imaging as part of their radiation therapy planning. All patients were observed for at least six months following their treatment, with a mean follow-up time of 32 months.

Overall survival of the 42 study patients was 82.8 percent at two years and 74.1 percent at three years, superior to the survival rate that was found in a Radiation Therapy Oncology Group study in which patients received standard fractionation or accelerated fractionation with concomitant boost. That study was the largest randomized trial of radiation therapy in locally advanced head and neck cancer.

Disease free survival for the 42 study patients was 71 percent and 66.9 percent at two and three years respectively. The cumulative incidence of recurrence was 18.7 percent. The study also found that standard uptake value is not a good predictor of local recurrence and that dose escalation based on standard uptake value is unlikely to be a fruitful treatment strategy.

“By combining the use of PET/CT imaging we are enhancing our ability to more effectively detect and deliver targeted radiation therapy to tumors,” said Hal Jacobson, M.D., medical director of InterCommunity Cancer Centers in Leesburg. “This study clearly demonstrates that we can reduce side-effects, and more importantly achieve superior clinical outcomes when using these imaging technologies in tandem as opposed to using CT imaging alone.”

For more information on radiation therapy services or to schedule an appointment with Dr. Hal Jacobson or Dr. Herman Flink, please call InterCommunity Cancer Centers at Leesburg, Lady Lake and Clermont at (352) 326-2224 or log on to www.iccancer.com

 

 

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