Upfront PET/CT affects management decisions in patients with recurrent head and neck squamous cell carcinoma

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Purpose: To compare multidisciplinary team conference (MDTC) decisions regarding treatment intent based on either chest X-ray + MRI of the head and neck (CXR/MRI) or 18 F-FDG-PET/CT (PET/CT) in patients with recurrent head and neck squamous cell carcinoma (HNSCC). Methods: Prospective blinded cohort study based on paired data. Consecutive patients with suspected recurrent HNSCC were invited to participate. All included patients underwent CXR/MRI and PET/CT before diagnostic biopsy. An ordinary MDTC using all available imaging data was conducted as per standard practice. After at least three months (to eliminate recall bias in the team), the first project MDTC, based on either CXR/MRI or PET/CT, was conducted, and the tumor board made conclusions regarding treatment. After an additional three months, a second project MDTC was conducted using the complementary imaging strategy. The separate treatment strategies were compared using McNemar's test. Results: A total of 110 patients (90 males and 20 females, median age 66 years, range 40–87) were included. The initial primary tumor originated from the pharynx in 56 (51%) patients, oral cavity in 17 (15%) patients, and larynx in 37 (34%) patients. Based on CXR/MRI, 87 patients (79%) were recommended curative treatment and 23 (21%) palliative treatment. Based on PET/CT, the MDTC decided that 52 (47%) patients were suitable for curative treatment and 58 (53%) for palliative treatment. The absolute difference of 32% was statistically significant (95% CI: 22–42%, p < 0.001). Conclusions: PET/CT affected MDTC decisions in patients with recurrent HNSCC towards less curative and more palliative treatment.

OriginalsprogEngelsk
TidsskriftOral Oncology
Vol/bind94
Sider (fra-til)1-7
ISSN1368-8375
DOI
StatusUdgivet - 1. jul. 2019

Fingeraftryk

Palliative Care
Larynx
Neoplasms
Cohort Studies
X-Rays

Citer dette

@article{92c64f09b77848d29a49f41421fbb42e,
title = "Upfront PET/CT affects management decisions in patients with recurrent head and neck squamous cell carcinoma",
abstract = "Purpose: To compare multidisciplinary team conference (MDTC) decisions regarding treatment intent based on either chest X-ray + MRI of the head and neck (CXR/MRI) or 18 F-FDG-PET/CT (PET/CT) in patients with recurrent head and neck squamous cell carcinoma (HNSCC). Methods: Prospective blinded cohort study based on paired data. Consecutive patients with suspected recurrent HNSCC were invited to participate. All included patients underwent CXR/MRI and PET/CT before diagnostic biopsy. An ordinary MDTC using all available imaging data was conducted as per standard practice. After at least three months (to eliminate recall bias in the team), the first project MDTC, based on either CXR/MRI or PET/CT, was conducted, and the tumor board made conclusions regarding treatment. After an additional three months, a second project MDTC was conducted using the complementary imaging strategy. The separate treatment strategies were compared using McNemar's test. Results: A total of 110 patients (90 males and 20 females, median age 66 years, range 40–87) were included. The initial primary tumor originated from the pharynx in 56 (51{\%}) patients, oral cavity in 17 (15{\%}) patients, and larynx in 37 (34{\%}) patients. Based on CXR/MRI, 87 patients (79{\%}) were recommended curative treatment and 23 (21{\%}) palliative treatment. Based on PET/CT, the MDTC decided that 52 (47{\%}) patients were suitable for curative treatment and 58 (53{\%}) for palliative treatment. The absolute difference of 32{\%} was statistically significant (95{\%} CI: 22–42{\%}, p < 0.001). Conclusions: PET/CT affected MDTC decisions in patients with recurrent HNSCC towards less curative and more palliative treatment.",
keywords = "Head and neck neoplasms, MDTC, Patient management, PET/CT, Recurrence, Treatment plan",
author = "Max Rohde and Nielsen, {Anne L.} and J{\o}rgen Johansen and S{\o}rensen, {Jens A.} and Anabel Diaz and Manan Pareek and Asmussen, {Jon T.} and Oke Gerke and Anders Thomassen and Niels Gyldenkerne and Helle D{\o}ssing and Kristine Bj{\o}rndal and H{\o}ilund-Carlsen, {Poul Flemming} and Christian Godballe",
year = "2019",
month = "7",
day = "1",
doi = "10.1016/j.oraloncology.2019.04.025",
language = "English",
volume = "94",
pages = "1--7",
journal = "Oral Oncology",
issn = "1368-8375",
publisher = "Pergamon Press",

}

TY - JOUR

T1 - Upfront PET/CT affects management decisions in patients with recurrent head and neck squamous cell carcinoma

AU - Rohde, Max

AU - Nielsen, Anne L.

AU - Johansen, Jørgen

AU - Sørensen, Jens A.

AU - Diaz, Anabel

AU - Pareek, Manan

AU - Asmussen, Jon T.

AU - Gerke, Oke

AU - Thomassen, Anders

AU - Gyldenkerne, Niels

AU - Døssing, Helle

AU - Bjørndal, Kristine

AU - Høilund-Carlsen, Poul Flemming

AU - Godballe, Christian

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Purpose: To compare multidisciplinary team conference (MDTC) decisions regarding treatment intent based on either chest X-ray + MRI of the head and neck (CXR/MRI) or 18 F-FDG-PET/CT (PET/CT) in patients with recurrent head and neck squamous cell carcinoma (HNSCC). Methods: Prospective blinded cohort study based on paired data. Consecutive patients with suspected recurrent HNSCC were invited to participate. All included patients underwent CXR/MRI and PET/CT before diagnostic biopsy. An ordinary MDTC using all available imaging data was conducted as per standard practice. After at least three months (to eliminate recall bias in the team), the first project MDTC, based on either CXR/MRI or PET/CT, was conducted, and the tumor board made conclusions regarding treatment. After an additional three months, a second project MDTC was conducted using the complementary imaging strategy. The separate treatment strategies were compared using McNemar's test. Results: A total of 110 patients (90 males and 20 females, median age 66 years, range 40–87) were included. The initial primary tumor originated from the pharynx in 56 (51%) patients, oral cavity in 17 (15%) patients, and larynx in 37 (34%) patients. Based on CXR/MRI, 87 patients (79%) were recommended curative treatment and 23 (21%) palliative treatment. Based on PET/CT, the MDTC decided that 52 (47%) patients were suitable for curative treatment and 58 (53%) for palliative treatment. The absolute difference of 32% was statistically significant (95% CI: 22–42%, p < 0.001). Conclusions: PET/CT affected MDTC decisions in patients with recurrent HNSCC towards less curative and more palliative treatment.

AB - Purpose: To compare multidisciplinary team conference (MDTC) decisions regarding treatment intent based on either chest X-ray + MRI of the head and neck (CXR/MRI) or 18 F-FDG-PET/CT (PET/CT) in patients with recurrent head and neck squamous cell carcinoma (HNSCC). Methods: Prospective blinded cohort study based on paired data. Consecutive patients with suspected recurrent HNSCC were invited to participate. All included patients underwent CXR/MRI and PET/CT before diagnostic biopsy. An ordinary MDTC using all available imaging data was conducted as per standard practice. After at least three months (to eliminate recall bias in the team), the first project MDTC, based on either CXR/MRI or PET/CT, was conducted, and the tumor board made conclusions regarding treatment. After an additional three months, a second project MDTC was conducted using the complementary imaging strategy. The separate treatment strategies were compared using McNemar's test. Results: A total of 110 patients (90 males and 20 females, median age 66 years, range 40–87) were included. The initial primary tumor originated from the pharynx in 56 (51%) patients, oral cavity in 17 (15%) patients, and larynx in 37 (34%) patients. Based on CXR/MRI, 87 patients (79%) were recommended curative treatment and 23 (21%) palliative treatment. Based on PET/CT, the MDTC decided that 52 (47%) patients were suitable for curative treatment and 58 (53%) for palliative treatment. The absolute difference of 32% was statistically significant (95% CI: 22–42%, p < 0.001). Conclusions: PET/CT affected MDTC decisions in patients with recurrent HNSCC towards less curative and more palliative treatment.

KW - Head and neck neoplasms

KW - MDTC

KW - Patient management

KW - PET/CT

KW - Recurrence

KW - Treatment plan

U2 - 10.1016/j.oraloncology.2019.04.025

DO - 10.1016/j.oraloncology.2019.04.025

M3 - Journal article

C2 - 31178202

AN - SCOPUS:85065093079

VL - 94

SP - 1

EP - 7

JO - Oral Oncology

JF - Oral Oncology

SN - 1368-8375

ER -