PET/CT planning beneficial for head and neck cancer patients

March 04, 2008

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 5 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.

"PET/CT provides a higher level of confidence that we are not missing tumors as we attempt to lessen treatment side effects by delivering radiation therapy that tightly conforms in three dimensions to a given tumor volume," said Christopher Schultz, M.D., professor of radiation oncology at the Medical College of Wisconsin. "Most importantly the PET/CT guided conformal radiotherapy was clearly no worse, and based on our early results may in fact lead to superior clinical outcomes as compared to CT only planned radiotherapy."
-end-
ASTRO is the largest radiation oncology society in the world, with 9,000 members who specialize in treating patients with radiation therapies. As the leading organization in radiation oncology, biology and physics, the Society is dedicated to improving patient care through education, clinical practice, advancement of science and advocacy.

American Society for Radiation Oncology

Related Radiation Therapy Articles from Brightsurf:

Pulmonary artery thrombosis a complication of radiation therapy
According to ARRS' American Journal of Roentgenology, the imaging findings of in situ pulmonary artery thrombosis (PAT) associated with radiation therapy (RT) are different from those of acute pulmonary emboli and do not appear to embolize.

New approach for calculating radiation dosimetry allows for individualized therapy
Researchers have developed a simplified process that could enhance personalization of cancer therapy based on a single nuclear medicine scan.

Developing microbeam radiation therapy (MRT) for inoperable cancer
An innovative radiation treatment that could one day be a valuable addition to conventional radiation therapy for inoperable brain and spinal tumors is a step closer, thanks to new research led by University of Saskatchewan (USask) researchers at the Canadian Light Source (CLS).

Travel considerations specified for 177Lu-DOTATATE radiation therapy patients
Researchers and patient advocates have addressed the challenges related to traveling after receiving 177Lu-DOTATATE radiation therapy in a study published in the April issue of The Journal of Nuclear Medicine.

A new way to monitor cancer radiation therapy doses
More than half of all cancer patients undergo radiation therapy and the dose is critical.

AI can jump-start radiation therapy for cancer patients
Artificial intelligence can help cancer patients start their radiation therapy sooner -- and thereby decrease the odds of the cancer spreading -- by instantly translating complex clinical data into an optimal plan of attack.

Towards safer, more effective cancer radiation therapy using X-rays and nanoparticles
X-rays could be tuned to deliver a more effective punch that destroys cancer cells and not harm the body.

Radiation therapy effective against deadly heart rhythm
A single high dose of radiation aimed at the heart significantly reduces episodes of a potentially deadly rapid heart rhythm, according to results of a phase one/two study at Washington University School of Medicine in St.

New mathematical model can improve radiation therapy of brain tumours
Researchers have developed a new model to optimize radiation therapy and significantly increase the number of tumor cells killed during treatment.

Using artificial intelligence to deliver personalized radiation therapy
New Cleveland Clinic-led research shows that artificial intelligence (AI) can use medical scans and health records to personalize the dose of radiation therapy used to treat cancer patients.

Read More: Radiation Therapy News and Radiation Therapy Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.