Usefulness of surveillance imaging in patients with head and neck cancer who are treated with definitive radiotherapy

被引：35

作者：

Ng, Sweet Ping ^{[1
]}

Pollard, Courtney, III ^{[1
]}

Berends, Joel ^{[2
]}

Ayoub, Zeina ^{[1
]}

Kamal, Mona ^{[1
,3
]}

Garden, Adam S. ^{[1
]}

Bahig, Houda ^{[1
]}

Cantor, Scott B. ^{[4
]}

Schaefer, Andrew J. ^{[5
]}

Ajayi, Temitayo ^{[5
]}

Gunn, G. Brandon ^{[1
]}

Frank, Steven J. ^{[1
]}

Skinner, Heath ^{[1
]}

Phan, Jack ^{[1
]}

Morrison, William H. ^{[1
]}

Ferrarotto, Renata ^{[6
]}

Johnson, Jason M. ^{[7
]}

Mohamed, Abdallah S. R. ^{[1
]}

Lai, Stephen Y. ^{[8
]}

Hessel, Amy C. ^{[8
]}

Sturgis, Erich M. ^{[8
]}

Weber, Randal S. ^{[8
]}

Fuller, Clifton D. ^{[1
]}

Rosenthal, David, I ^{[1
]}

机构：

[1] Univ Texas MD Anderson Canc Ctr, Dept Radiat Oncol, Div Radiat Oncol, 1515 Holcombe Blvd, Houston, TX 77030 USA

[2] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA

[3] Ain Shams Univ, Dept Clin Oncol, Cairo, Egypt

[4] Univ Texas MD Anderson Canc Ctr, Dept Hlth Serv Res, Houston, TX 77030 USA

[5] Rice Univ, Dept Computat & Appl Math, Houston, TX USA

[6] Univ Texas MD Anderson Canc Ctr, Dept Thorac Head & Neck Med Oncol, Div Canc Med, Houston, TX 77030 USA

[7] Univ Texas MD Anderson Canc Ctr, Dept Diagnost Radiol, Houston, TX 77030 USA

[8] Univ Texas MD Anderson Canc Ctr, Dept Head & Neck Surg, Div Surg, Houston, TX 77030 USA

来源：

CANCER | 2019年 / 125卷 / 11期

关键词：

definitive; head and neck; imaging; radiotherapy; surveillance; SQUAMOUS-CELL CARCINOMA; ROUTINE FOLLOW-UP; COST; PET/CT; PHYSICIANS; RECURRENT;

D O I：

10.1002/cncr.31983

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background The current study was performed to assess the efficacy of surveillance imaging in patients with head and neck cancer (HNC) who are treated definitively with radiotherapy. Methods Eligible patients included those with a demonstrable disease-free interval (>= 1 follow-up imaging procedure without evidence of disease and a subsequent visit/imaging procedure) who underwent treatment of HNC from 2000 through 2010. Results A total of 1508 patients were included. The median overall survival was 99 months, with a median imaging follow-up period of 59 months. Of the 1508 patients, 190 patients (12.6%) experienced disease recurrence (107 patients had locoregional and 83 had distant disease recurrence). A total of 119 patients (62.6%) in the group with disease recurrence were symptomatic and/or had an adverse clinical finding associated with the recurrence. Approximately 80% of patients with locoregional disease recurrences presented with a clinical finding, whereas 60% of distant disease recurrences were detected by imaging in asymptomatic patients. Despite the earlier detection of disease recurrence via imaging, those patients in the group of patients with clinically detected disease recurrence were significantly more likely to undergo salvage therapy compared with those whose recurrence was detected on imaging (odds ratio, 0.35). There was no difference in overall survival noted between those patients with disease recurrences that were detected clinically or with imaging alone. Approximately 70% of disease recurrences occurred within the first 2 years. In those patients who developed disease recurrence after 2 years, the median time to recurrence was 51 months. After 2 years, the average number of imaging procedures per patient for the detection of a salvageable recurrence for the imaging-detected group was 1539. Conclusions Surveillance imaging in asymptomatic patients with HNC who are treated definitively with radiotherapy without clinically suspicious findings beyond 2 years has a low yield and a high cost. Physicians ordering these studies must use judicious consideration and discretion.

引用

页码：1823 / 1829

页数：7