Di Martino E, Hausmann R, Krombach G A, Nowak B, Tietze L, Gagel B, Zimny M, Westhofen M
Klinik für Hals-Nasen- und Ohren-Heilkunde und Plastische Kopf- und Halschirurgie der Med. Fakultät der RWTH Aachen.
Laryngorhinootologie. 2002 Dec;81(12):866-74. doi: 10.1055/s-2002-36101.
Head and neck malignancies have a high rate of recurrences. Since the prognosis is often limited an early detection and therapy onset is essential for survival. This study surveys the relevance of regular colour-duplex echography examinations in the follow-up for detection and therapy of recurrent head and neck carcinomas.
In a prospective non-randomized study 43 patients were surveyed over a mean observation period of 28 (8-44) months. In addition to clinical and colour-duplex echography (CDS) examinations, computed tomography (CT) and positron-emission-tomography using 18fluorodeoxyglucose (PET) were performed.
A recurrence was detected in 17/43 (39.5 %) patients. The median survival was 42 months. CDS was the most reliable procedure for the diagnosis of regional recurrences with an accuracy of 94.2 %. Sensitivity and specificity of CDS for the diagnosis of all recurrences was found to be 80 % and 78,6 % respectively. CT yielded identical results. In PET sensitivity was 82.4 % and specificity was found to be 88.4 %. In clinical examinations including panendoscopy sensitivity was 64.7 % only. In 7/17 recurrences a therapy was performed with curative intention. In 4 cases an early diagnosis by CDS contributed to a successful therapy.
CDS is the imaging procedure of choice for the routine follow-up of head and neck cancer patients. In order to perform a comprehensive assessment of the head and neck region, for re-staging and to exclude second primary tumours additional (pan)endoscopy is necessary. CDS supports due to a high resolution and reliability an early therapy onset and a minimal invasive therapy. Thus, this procedure can significantly contribute to the successful treatment of recurrences in head and neck cancer.
头颈部恶性肿瘤复发率很高。由于预后往往有限，早期检测和开始治疗对生存至关重要。本研究调查了定期彩色双功超声检查在复发性头颈部癌检测和治疗随访中的相关性。
在一项前瞻性非随机研究中，对43例患者进行了平均28（8 - 44）个月的观察。除了临床和彩色双功超声（CDS）检查外，还进行了计算机断层扫描（CT）和使用18氟脱氧葡萄糖的正电子发射断层扫描（PET）。
17/43（39.5%）例患者检测到复发。中位生存期为42个月。CDS是诊断局部复发最可靠的方法，准确率为94.2%。发现CDS诊断所有复发的敏感性和特异性分别为80%和78.6%。CT得出相同结果。PET的敏感性为82.4%，特异性为88.4%。在包括全内镜检查的临床检查中，敏感性仅为64.7%。17例复发中有7例进行了根治性治疗。4例通过CDS早期诊断有助于成功治疗。
CDS是头颈部癌患者常规随访的首选影像学检查方法。为了对头颈部区域进行全面评估、重新分期并排除第二原发性肿瘤，需要额外进行（全）内镜检查。由于高分辨率和可靠性，CDS有助于早期开始治疗和微创治疗。因此，该检查方法可显著有助于头颈部癌复发的成功治疗。
