Accuracy of positron emission tomography in the evaluation of patients treated with chemoradiotherapy for mucosal head and neck cancer.

Abstract

The aim of this study was to evaluate the accuracy of positron emission tomography (PET) in assessing the patients treated with primary chemoradiotherapy for mucosal carcinoma of the head and neck. A retrospective review of patients with biopsy-proven cancer of mucosal head and neck sites receiving chemoradiotherapy with curative intent was undertaken. Seventy-eight patients met the study criteria. Staging PET identified unsuspected distant metastatic disease in 11% of patients. Sixty-one patients (78%) had a complete metabolic response on PET, with 17 showing residual disease. Sensitivity of PET was 82% (positive predictive value: 82%) and specificity was 95% (negative predictive value: 95%). Accuracy of PET response was significantly better than clinical assessment and conventional imaging (p < .002, p < .001, respectively). PET has been found to be significantly better than clinical examination or conventional imaging in restaging patients after chemoradiotherapy. Patients with a complete response on posttreatment PET have a significant survival advantage and can be safely observed.