Pilot study of positron emission tomography in patients with advanced head and neck cancer receiving radiotherapy and chemotherapy

Head Neck. Jul-Aug 1994;16(4):340-6. doi: 10.1002/hed.2880160408.

Abstract

Background: Positron emission tomography (PET) provides a noninvasive modality for evaluating the biochemical processes of normal and pathologic tissue. Preliminary reports of F-18 fluorodeoxyglucose (FDG) PET indicate its potential usefulness in evaluating head and neck tumors. The current study was performed to explore the relationship between changes in tumor FDG metabolism and local control in patients receiving hyperfractionated radiotherapy and concurrent chemotherapy.

Methods: The study group consisted of six patients with locally advanced, nonmetastatic squamous cell carcinoma of the head and neck. FDG studies were performed prior to, during, and 24 months post-therapy. Ratios of tumor to nontumor FDG uptake in regions of interest (ROI) were compared.

Results: All pretherapy studies demonstrated a focal hypermetabolic abnormality corresponding to the known tumor. The pretherapy tumor to nontumor FDG ratios declined significantly during therapy (p < 0.05) with a similar continued trend post-therapy (p < 0.07).

Conclusion: The treatment-induced decrease in tumor hypermetabolism as seen on serial FDG PET parallels the clinical response in squamous carcinoma of the head and neck. Two-year follow-up scans also suggest that continued low tumor to nontumor ratios reflect eradication of local disease. Because of its high cost, a study of larger numbers of patients is necessary to better define the role of PET in the management of head and neck cancer.

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Carcinoma, Squamous Cell / diagnostic imaging*
  • Carcinoma, Squamous Cell / metabolism
  • Carcinoma, Squamous Cell / therapy*
  • Combined Modality Therapy
  • Deoxyglucose / analogs & derivatives
  • Deoxyglucose / metabolism
  • Female
  • Fluorodeoxyglucose F18
  • Follow-Up Studies
  • Head and Neck Neoplasms / diagnostic imaging*
  • Head and Neck Neoplasms / metabolism
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Radiotherapy
  • Time Factors
  • Tomography, Emission-Computed / methods*

Substances

  • Fluorodeoxyglucose F18
  • Deoxyglucose