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18F-Fluorodeoxyglucose-PET/CT in locally advanced head and neck cancer can influence the stage migration and nodal radiation treatment volumes

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Abstract

Aim

To analyze the impact of 18F-fluorodeoxyglucose-PET/CT (PET/CT) in the radiotherapy (RT) planning strategy in HNC, correlating CT-scan and PET/CT performances.

Materials and methods

Inclusion criteria were: age >18 years old, histologically proven head and neck cancer (HNC), patients candidate to definitive RT ± chemotherapy, stage of disease by means of PET/TC and CT-scan performed at our Cancer Care Center.

Results

Sixty patients were analyzed. The following primary tumor sites were investigated: nasopharynx (13%), oropharynx (42%), oral cavity (32%) and larynx non-glottic (13%). Globally, PET/CT findings caused changes on nodal radiation treatment volumes in 10% of all the population of study. Specifically, in 5 cases out of 19 oral cavity tumors (26%), PET/CT detected neck-nodes positive (not detected at CT-scan). These findings have allowed to change the patients management, including PET/CT neck-nodes positive in the high-risk RT volumes.

Conclusion

In the RT planning strategy, the present findings support the use of PET/CT to improve upfront regional staging of HNC disease, particularly for oral cavity tumors. Further investigations are advocated to evaluate if this strategy could impact on long-term outcomes in terms of local control and overall survival.

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Authors and Affiliations

  1. Radiation Oncology, Sacro Cuore Don Calabria Hospital, Negrar-Verona, Italy

    Rosario Mazzola, Francesco Ricchetti, Alba Fiorentino, Sergio Fersino, Niccolò Giaj-Levra & Filippo Alongi

  2. Nuclear Medicine, Fondazione Giglio, Cefalù, Italy

    Pierpaolo Alongi

  3. Nuclear Medicine, Sacro Cuore Don Calabria Hospital, Negrar-Verona, Italy

    Matteo Salgarello

  4. University of Brescia, Brescia, Italy

    Filippo Alongi

Authors
  1. Rosario Mazzola
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  2. Pierpaolo Alongi
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  3. Francesco Ricchetti
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  4. Alba Fiorentino
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  5. Sergio Fersino
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  6. Niccolò Giaj-Levra
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  7. Matteo Salgarello
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  8. Filippo Alongi
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Corresponding author

Correspondence to Rosario Mazzola.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Conflict of interest

The authors declare that they have no conflict of interest. Informed consent was obtained from all individual participants included in the study.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Mazzola, R., Alongi, P., Ricchetti, F. et al. 18F-Fluorodeoxyglucose-PET/CT in locally advanced head and neck cancer can influence the stage migration and nodal radiation treatment volumes. Radiol med 122, 952–959 (2017). https://doi.org/10.1007/s11547-017-0804-0

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  • DOI: https://doi.org/10.1007/s11547-017-0804-0

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