Resumen de Impact of initial FDG PET/CT in the management plan of patients with locally advanced head and neck cancer
Fernando Arias de la Vega, V. Chicata, María José García Velloso, Gemma Asín Felipe, María Uzcanga Lacabe, Clara Eíto Valdovinos, I. Quílez Sardá, A. Viudez, J. Sáenz Bañuelos, I. Hernández, Carlos Caicedo Zamudio, M. Errasti Viader, Marta Barrado Los Arcos, F. García-Bragado Acín
Objective To determine the impact of initial FDG PET/CT staging on clinical stage and the management plan in patients with locally advanced head and neck cancer (LAHNC).
Materials and methods We retrospectively reviewed the records of 72 consecutive patients (2007�2010) staged with PET/CT and conventional CT with tumours of hypopharynx/larynx (26 patients, 36 %), oral cavity (17 patients, 24 %), oropharynx (16 patients, 22 %), nasopharynx (12 patients, 17 %), and others (2 %). The impact of PET/CT on management plans was considered high when PET/CT changed the planned treatment modality or treatment intent, and intramodality changes were considered as minor changes with low impact.
Results FDG PET/CT changed the stage in 27 patients and had high impact on the management plan in 12 % of patients (detection of distant metastases in 6 patients and stage II in 2 patients). Intramodality changes were more frequent: FDG PET/CT altered the TNM stage in 18/72 (25 %) of patients, upstaging N stage in 90 % of patients with low impact.
Conclusions Initial FDG PET/CT staging not only improves stage but also affects the management plan in LAHNC patients.
