Schwartz David L, Rajendran Joseph, Yueh Bevan, Coltrera Marc, Anzai Yoshimi, Krohn Kenneth, Eary Janet
Department of Radiation Oncology, Division of Nuclear Medicine, VA Puget Sound Health Care System and University of Washington, Seattle 98108, USA.
Arch Otolaryngol Head Neck Surg. 2003 Nov;129(11):1173-8. doi: 10.1001/archotol.129.11.1173.
Accurate baseline staging is necessary to appropriately treat head and neck squamous cell carcinoma. [F-18]-fluorodeoxyglucose positron emission tomography (FDG-PET) is valuable for locoregional staging of primary head and neck disease. The effectiveness of FDG-PET for the detection of distant metastatic or synchronous disease remains unproven.
To investigate the utility of FDG-PET extended into the abdomen (extended-field FDG-PET) for wide-field staging of head and neck tumors.
This is a prospective institutional study of 35 consecutive patients diagnosed with American Joint Committee on Cancer (AJCC)-defined stage II-IV squamous cell carcinoma of the oral cavity, oropharynx, or larynx between September 2000 and June 2002. Thirty-three patients (94%) were eligible for analysis. All patients were routinely staged with chest radiography, liver function tests, and extended-field FDG-PET. Chest or abdominal computed tomographic scans were used as corroborative studies and were obtained only when one of the above tests indicated distant disease.
Of 33 patients, 7 (21%) had evidence of distant disease by extend-field FDG-PET-4 with metastases and 3 with synchronous primary cancers of the aerodigestive tract. [F-18]-fluorodeoxyglucose PET detected hepatic, bone, gastrointestinal, and mediastinal disease not identified by chest radiography or liver function tests. Two of the 7 patients with FDG-avid distant disease had false-negative staging by all other tests, including computed tomography.
Extended-field FDG-PET is feasible and may improve staging of primary head and neck squamous cell carcinoma. Use of staging FDG-PET must be explicitly described in reports from centers engaged in prospective research to facilitate comparison with historical results.
准确的基线分期对于头颈部鳞状细胞癌的恰当治疗至关重要。[F-18]氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）对头颈部原发性疾病的局部区域分期具有重要价值。FDG-PET在检测远处转移或同步性疾病方面的有效性尚未得到证实。
探讨扩展至腹部的FDG-PET（扩展野FDG-PET）在头颈部肿瘤广域分期中的应用价值。
这是一项前瞻性机构研究，纳入了2000年9月至2002年6月期间连续诊断为美国癌症联合委员会（AJCC）定义的II-IV期口腔、口咽或喉鳞状细胞癌的35例患者。33例患者（94%）符合分析条件。所有患者均常规进行胸部X线摄影、肝功能检查和扩展野FDG-PET检查。胸部或腹部计算机断层扫描用作辅助检查，仅在上述检查之一提示有远处疾病时才进行。
33例患者中，7例（21%）通过扩展野FDG-PET有远处疾病证据——4例有转移，3例有上呼吸道消化道同步原发性癌症。[F-18]氟脱氧葡萄糖PET检测到了胸部X线摄影或肝功能检查未发现的肝脏、骨骼、胃肠道和纵隔疾病。7例FDG摄取阳性的远处疾病患者中有2例通过包括计算机断层扫描在内的所有其他检查出现分期假阴性。
扩展野FDG-PET是可行的，可能会改善原发性头颈部鳞状细胞癌的分期。参与前瞻性研究的中心在报告中必须明确描述分期FDG-PET的使用情况，以便于与历史结果进行比较。
