Southern Illinois School Of MedicineWe had mentioned in an earlier article as to how a novel treatment may prove to be advantageous to head and neck cancer patients.

Now a new study claims that a combination of imaging tests performed 6 to 8 weeks after patients finish chemoradiotherapy for head and neck cancer may assist in recognizing patients who may react to treatment well and those who could need surgical follow-up.

During the past two decades, chemoradiotherapy combining chemotherapy and radiation treatments has apparently become significant in aiding to conserve organs while treating advanced head and neck cancers. This was provided as background information.

The authors commented, “These non-surgical approaches produce an excellent response at the primary tumor site and cervical lymph nodes resulting in high rates of locoregional disease control. Accurate and timely assessment of disease response at the primary tumor site and cervical lymph nodes after chemoradiotherapy is essential to detect residual disease, to direct surgical salvage and to prevent tumor recurrence.”

Approximately 31 patients with advanced-stage head and neck cancer who were treated with chemoradiotherapy between 2004 and 2006 were examined by James P. Malone, M.D., of the Southern Illinois School of Medicine, Springfield, and colleagues. Each patient apparently went through combined positron emission tomography and computed tomography (PET-CT) to identify proof of constant tumors six to eight weeks following the completion of treatment. They were then apparently trailed for a median of around 24 months.

Evaluating the reaction of the tumor to treatment with PET-CT apparently had sensitivity i.e. rate of true positives of around 83 percent, specificity i.e. rate of true negatives of around 54 percent, positive predictive value i.e. likelihood that patients who test positive suffer from the disease of 31 percent and negative predictive value i.e. odds that patients who test negative do not suffer from the disease of 92 percent.

In the 21 patients whose disease had apparently extended to adjacent lymph nodes prior to treatment, sensitivity was claimed to be 75 percent; specificity, supposedly more than 94 percent; positive predictive value was alleged to be more than 75 percent; and negative predictive value was apparently 94 percent. For the remaining ten whose cancer was believed to be positioned in the neck only, specificity was said to be 92 percent and negative predictive value was apparently more than 92 percent.

The authors remarked, “On the basis of this study, PET-CT performed six to eight weeks after the completion of intra-arterial chemoradiotherapy for advanced squamous cell carcinoma of the head and neck is a valuable tool for measuring treatment response and facilitating clinical decision making. In addition to early prediction of treatment response, PET-CT provides early detection of distant metastases, which permits earlier intervention in patients with distant disease.”

The authors concluded by mentioning that further investigations of PET-CT in homogenously treated patient populations with consistent timing of post-treatment scans are necessary to more clearly elucidate the role of this imaging modality in the management of advanced squamous cell carcinoma of the head and neck.

The study was published in the Archives of Otolaryngology—Head & Neck Surgery, one of the JAMA/Archives journals.