Impact of FDG-PET to detect recurrence of head and neck squamous cell carcinoma

2007 ◽  
Vol 137 (4) ◽  
pp. 647-653 ◽  
Author(s):  
Sophie P$eAri$eA ◽  
Alexis Hugentobler ◽  
Bertrand Susini ◽  
Sona Balogova ◽  
Dany Grahek ◽  
...  
Keyword(s):  
Cell Carcinoma ◽  
Head And Neck ◽  
Fdg Pet ◽  
First Year ◽  
Therapeutic Impact ◽  
Curative Therapy ◽  
Positron Emission ◽  
Group A ◽  
Group B ◽  
The Impact

Objective Prospectively evaluate the impact of fluorodeoxy-glucose-fluorine-18 positron emission tomography (FDG-PET) in the management of recurrence of advanced head and neck squa-mous cell carcinoma during the first year after treatment. Study Design Seventy patients were followed-up every 6 to 8 weeks during the first year after initial combined curative therapy. FDG-PET, together with conventional imaging and en-doscopy were performed systematically at 1 year (group A) or prompted earlier in case of clinically suspicious recurrence (group B). The referring physician evaluated the impact of FDG-PET on the patient's management. Another clinician checked the pertinence of decisions. Results FDG-PET had a therapeutic impact in 8 of 43 group A patients and in 16 of 27 group B patients; the overall rate was 34%. This change was pertinent in 5 of 8 and 14 of 16 cases, respectively. Overall pertinence rate of decisions was 90% versus 70% without FDG-PET. Conclusions FDG-PET had a significant overall therapeutic impact; the induced decisions were either pertinent or just led to “futile” noninvasive examinations. Systematic FDG-PET had a significantly lesser impact in comparison with FDG-PET motivated by clinical suspicion.

Efficacy and tolerability of weekly 40mg/m² cisplatin radiosensitizing modified regimen for locally-advanced head and neck squamous cell carcinoma radical treatment with chemoradiotherapy: A university hospital experience.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e18512-e18512
Author(s):  
Bruna Bighetti ◽  
José Tristão Neto ◽  
Renata do Socorro Monteiro Pereira ◽  
LAÍS CRISTHINE SOUZA ◽  
Ilka Lopes Santoro ◽  
...  
Keyword(s):  
Overall Survival ◽  
Squamous Cell Carcinoma ◽  
Total Dose ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Neck Squamous Cell Carcinoma ◽  
Group A ◽  
Group B ◽  
Weekly Cisplatin

e18512 Background: Cisplatin-based chemoradiotherapy (CRT) is a well-established regimen used for adjuvant and/or head-and-neck squamous cell carcinoma (HNSCC) radical treatment. The most classic protocol for chemoradiotherapy remains the administration of Cisplatin 100mg/m² EV D1 q3-week period, 3 cycles. The objective of this study is to assess the efficacy and tolerability of the weekly 40mg/m² cisplatin regimen. Methods: we conducted a retrospective study from 2007-2020 with 102 patients treated at a national reference institution. All of them with HNSCC received concurrent CRT with weekly cisplatin 40mg/m² EV D1. We analyzed the overall survival (OS), local recurrence and tolerability in this scheme. Results: The median cisplatin cumulative dose received by our patients was 240mg/m². Hence, we divided them in two groups for the analysis: Group A (41 patients) received less than 240mg/m² cisplatin total dose and Group B (61 patients) received more or equal 240mg/m² cisplatin total dose. Both groups were equally balanced between sex, clinic stage, histologic grade and clinic status. We found that the Group A experienced 5 deaths (12.2%) while the Group B experienced 6 deaths (9.8%). The mean time to recurrence disease in the Group A was 45.68 months and in Group B 60.22 months (p = 0.958). The estimated overall survival in the Group A was 150 months and in the Group B was 116.4 months (p = 0.443). Conclusions: The weekly cisplatin dose regimen showed to be feasible, more tolerable, and less toxic and with no difference in terms of OS then the classic 3-week cisplatin protocol in the CRT setting. Our group suggests that the 240mg/m² cumulative cisplatin weekly schedule should be a better option for CRT treatments then the classic cisplatin regimen. A phase III clinical trial is warranted to further understanding of this framework. Key-words: head and neck cancer, cisplatin, radiotherapy

scholarly journals Control of Imported and Acquired Methicillin-resistant Staphylococcus aureus (MRSA) in Mechanically Ventilated Patients: A Dose-response Study of Enteral Vancomycin to Reduce Absolute Carriage and Infection

2005 ◽  
Vol 33 (3) ◽  
pp. 361-372 ◽  
Author(s):  
M. Viviani ◽  
H. K. F. Van Saene ◽  
R. Dezzoni ◽  
L. Silvestri ◽  
R. Di Lenarda ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
First Year ◽  
High Dose ◽  
Mechanically Ventilated ◽  
Group A ◽  
Second Year ◽  
The Absolute ◽  
Group B ◽  
Dose Response Study ◽  
The Impact

This study aimed to quantify the animate source provided by the patients using the concept of “absolute carriage” by multiplying the carrier rate by the level of carriage; and to compare the impact of a low and high dose of an oropha-ryngeal vancomycin gel on the absolute MRSA carriage and infection. In all, 265 patients were included, 126 were MRSA positive. Fifty-five patients received 2% vancomycin gel during the first year whilst 4% vancomycin gel was given to 50 patients during the second year. Surveillance swabs of throat and rectum were obtained from all eligible patients on admission and then twice weekly. The vancomycin protocol was started as soon as the surveillance cultures were positive for MRSA. Those patients received one gram of enteral vancomycin daily, divided into four doses. During the first year 2% vancomycin gel 4 ml (80 mg) was applied in the oropharynx in four doses in addition to the enteral solution (Group A). During the second year 4% vancomycin gel 4 ml (160 mg) was used (Group B). The absolute carriage was high during both periods: 3.6 for Group A, and 3.2 for Group B. The 4% vancomycin protocol significantly reduced the absolute carriage, compared to the 2% vancomycin protocol: 2.6 versus 1.5 (P<0.01). Significant reduction in secondary endogenous infections was found in the second year: seven versus 15 patients (P<0.05). A total of 3,588 microbiological samples were processed. Neither Staphylococcus aureus with intermediate sensitivity to vancomycin (VISA) nor vancomycin-resistant enterococci (VRE) were detected.

Surveillance for Recurrent Head and Neck Cancer Using Positron Emission Tomography

2000 ◽  
Vol 18 (3) ◽  
pp. 651-651 ◽  
Author(s):  
Val J. Lowe ◽  
James H. Boyd ◽  
Frank R. Dunphy ◽  
Han Kim ◽  
T. Dunleavy ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Fdg Pet ◽  
Cancer Recurrence ◽  
Emission Tomography ◽  
First Year ◽  
Correlative Imaging ◽  
Positron Emission

PURPOSE: Earlier detection of head and neck cancer recurrence may improve survival. We evaluated the ability of [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) to detect recurrence in a prospective trial using sequential PET scans. PATIENTS AND METHODS: Serial posttherapy FDG-PET was prospectively performed in 44 patients with stage III or IV head and neck cancer. PET was performed twice during the first posttreatment year (at 2 and 10 months after therapy) and thereafter as needed. After therapy, patients were grouped, based on tissue biopsies, into those who achieved a complete response (CR) and those who had residual disease (RD). Patients who achieved a CR were further grouped into those without evidence of disease and those who had recurrence by 1 year after completion of therapy. Disease status as determined by physical examination (PE), PET, and correlative imaging was compared. RESULTS: Eight patients were lost to follow-up and six had RD after therapy. Of the remaining 30 patients with a CR, 16 had recurrence in the first year after therapy. Five of these 16 patients had recurrence detected by PET only, four by PET and correlative imaging only, five by PE and PET only, and two by PE, correlative imaging, and PET. Only PET detected all recurrences in the first year. PET performed better than correlative imaging (P = .013) or PE (P = .002) in the detection of recurrence. CONCLUSION: PET can detect head and neck tumor recurrence when it may be undetectable by other clinical methods. FDG-PET permits highly accurate detection of head and neck cancer recurrence in the posttherapy period.

[18F]Fluorodeoxyglucose-Positron Emission Tomography in Patients with Medulloblastoma

Neurosurgery ◽  
2004 ◽  
Vol 55 (6) ◽  
pp. 1280-1289 ◽  
Author(s):  
Sridharan Gururangan ◽  
Eugene Hwang ◽  
James E. Herndon ◽  
Herbert Fuchs ◽  
Timothy George ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Qualitative Analysis ◽  
Fdg Pet ◽  
Resonance Imaging ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Fdg Pet Scan ◽  
Group A ◽  
Group B

Abstract OBJECTIVE: We evaluated the [18F]fluorodeoxyglucose (FDG) accumulation during positron emission tomography (PET) in patients with medulloblastoma and examined the relationship of intensity of uptake with patient outcome after the initial scan. METHODS: Magnetic resonance imaging and FDG-PET scans of brain and spine were used to assess FDG uptake by visual grade (qualitative analysis) and metabolic activity ratios (Tmax/Gmean and Tmax/Wmean). Patients were divided into two groups based on either confirmation of tumor by biopsy and/or death resulting from progressive disease after the initial FDG-PET scan (Group A) or no intervention for the suspected lesion shown on magnetic resonance imaging after the initial FDG-PET scan but currently alive without evidence of disease (Group B). RESULTS: Twenty-two patients with either recurrent (n = 21) or newly diagnosed (n = 1) medulloblastoma underwent brain (n = 18) or whole-body (n = 4) FDG-PET scans after magnetic resonance imaging evidence of suspected tumor. The median qualitative analysis was 3 (range, 0–4) in 17 Group A patients compared with 0 (range, 0–1) in 5 Group B patients (P = 0.0003). The mean Tmax/Gmean and Tmax/Wmean ratios for 16 Group A patients were 1.3 (range, 0.1–3.8) and 2.10 (range, 0.4–5.2), respectively, compared with 0.80 (range, 0.20–1.5) and 1.3 (range, 0.5–1.9) in 5 Group B patients (P = 0.2 for both parameters, not significant). There was a significant negative correlation between increased FDG uptake and survival. Higher qualitative analysis and Tmax/Wmean were associated with significantly poorer 2-year overall survival after the initial scan (71% versus 15% for qualitative analysis grade of &lt;3 versus ≥3, P = 0.001; 46% versus 0% for Tmax/Wmean ≤2.5 versus –2.5, P = 0.004). CONCLUSION: Increased FDG uptake is observed in medulloblastoma and is correlated negatively with survival.

scholarly journals Role of curcumin as an adjuvant in treatment of advanced head and neck squamous cell carcinoma

2018 ◽  
Vol 4 (6) ◽  
pp. 1388
Author(s):  
P. Arun ◽  
Sagayaraj A. ◽  
S. M. Azeem Mohiyuddin ◽  
D. Santosh
Keyword(s):  
Squamous Cell Carcinoma ◽  
Partial Response ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Stable Disease ◽  
Advanced Head ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> Chemoradiation forms the major line of treatment in advanced head and neck squamous cell carcinoma, but the benefit of chemotherapeutic agents is at the expense of various toxicities. Curcumin has demonstrated promising results in in-vivo and in-vitro studies as a radiosensitiser. The objective of the study was to determine the role of curcumin as an adjuvant in patients undergoing chemo radiation for advanced head and neck cancers.</p><p class="abstract"><strong>Methods:</strong> Study involved 21 patients who underwent chemo radiotherapy for advanced head and neck cancers. They were randomized into two groups. Group A received 500 mg of curcumin while, Group B received placebo along with chemoradiation. The response was assessed using RECIST criteria at three months post treatment using contrast enhanced computerized tomography scan.  </p><p class="abstract"><strong>Results:</strong> Overall 58.3% patients had partial response and 41.7% patients had stable disease in group A. In group B, 33.3% patients had a partial response and 66.6% patient had a stable disease.</p><p class="abstract"><strong>Conclusions:</strong> Patients receiving curcumin along with chemoradiation had a marginal decrease in tumour volume and 58.3% patients had partial response and 41.7% had stable disease. A statistical significance could not be achieved due to lack of stage-match controls. Further studies are required to validate the role of curcumin as an adjuvant in the treatment of head and neck squamous cell carcinomas.</p>

18F-FDG PET cannot predict expression of clinically relevant histopathological biomarkers in head and neck squamous cell carcinoma: a meta-analysis

2021 ◽  
pp. 028418512198897
Author(s):  
Alexey Surov ◽  
Maciej Pech ◽  
Alexander Eckert ◽  
Christoph Arens ◽  
Oliver Grosser ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Growth Factor ◽  
Tumor Cell ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Fdg Pet ◽  
Neck Squamous Cell Carcinoma ◽  
Histopathological Features ◽  
18F Fdg

Background Head and neck squamous cell carcinoma (HNSCC) is a common cancer. Positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG) is a widely used imaging modality in HNSCC. Purpose To provide evident data about associations between 18F-FDG PET and histopathology in HNSCC. Material and Methods The MEDLINE database was screened for associations between maximum standard uptake values (SUVmax) derived from 18F-FDG PET and histopathological features in HNSCC up to May 2020. Only papers containing correlation coefficients between SUVmax and histopathology were acquired. Overall, 23 publications were collected. Results The following correlations were calculated: KI 67: 12 studies (345 patients), pooled correlation coefficient (PCC): 0.23 (95% confidence interval [CI] 0.06–0.40); hypoxia-inducible factor-1α: eight studies (240 patients), PCC: 0.24 (95% CI 0.06–0.42); microvessel density: three studies (64 patients), PCC: 0.33 (95% CI 0.02–0.65); vascular endothelial growth factor: two studies (59 cases), PCC: 0.27 (95% CI 0.02–0.51); tumor suppressor protein p53: four studies (159 patients), PCC: 0.05 (95% CI –0.41 to 0.51); epidermal growth factor receptor: two studies (124 patients), PCC: 0.21 (95% CI 0.05–0.37); tumor cell count: three studies (67 patients), PCC: 0.18 (95% CI –0.06 to 0.42); tumor cell apoptosis: two studies (40 patients), PCC: 0.07 (95% CI = –0.85 to 0.99); B-cell lymphoma-2 protein: two studies (118 patients); PCC: 0.04 (95% CI –0.65 to 0.74); glucose-transporter 1: 10 studies (317 patients), PCC: 0.20 (95% CI 0.10–0.30). Conclusion SUVmax derived from 18F-FDG PET cannot reflect relevant histopathological features in HNSCC.

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