PET-CT in Recurrent Head Neck Cancers: A Study to Evaluate Impact on Patient Management

Background and Objectives: PET-CT has shown promise in the management of head neck cancers. However, there have been only few studies evaluating its impact on management of patients with recurrent cancers in the presence of available clinicoradiologic methods of assessment. We conducted this study to assess the same in patients with suspected recurrent head and neck cancer. Methods: Case histories were presented to two oncologists, who were blinded to PET-CT reports. Treatment plans were made by these oncologists based on clinical findings and other conventional imaging. These plans were then compared to the actual treatment received by patients after PET-CT. Any change was recorded as "change in management." Results: Forty-nine patients with suspected recurrent head and neck cancer were evaluated in the Study. Overall, there was a 38.7% change in management because of the addition of PET-CT to conventional methods of assessment. Eight patients (16.3%) had a major change in therapy while in I I patients (22.4%). diagnostic procedures like endoscopies, biopsies and examination under anesthesia were avoided. Conclusion: In our study, PET-CT had a significant impact on the management of patients with suspected recurrent head neck cancer. J. Surg. Oncol 2009;100:401-403. (C) 2009 Wiley-Liss, Inc.