OncoRay - National Center for Radiation Research in Oncology, Biological and Molecular Imaging, Medical Faculty and University Hospital Carl Gustav Carus, Dresden, Germany.
Strahlenther Onkol. 2013 Mar;189(3):197-201. doi: 10.1007/s00066-012-0283-0. Epub 2013 Jan 19.
Reliable tumor staging is a fundamental pre-requisite for efficient tumor therapy and further prognosis. The aim of this study was to compare head and neck cancer (HNC) staging before and after FDG-PET/CT, evaluating the stage modifications for radiotherapy (RT) planning.
A total of 102 patients with untreated primary HNC, who underwent conventional staging and staging including FDG-PET/CT before RT, were enrolled in this retrospective study. Blinded pre-FDG-PET/CT and post-FDG-PET/CT staging data were compared. The impact on patient management was tested by comparing the intention before and after FDG-PET/CT.
Significant modifications of T, N, and M stage as well as clinical stage were detected after inclusion of FDG-PET/CT data (p = 0.002, 0.0006, 0.001, 0.03, respectively). Overall, the implementation of FDG-PET/CT led to modification of RT intention decision in 14 patients.
FDG-PET/CT demonstrates essential influence on tumor staging in HNC patients scheduled for irradiation. Implementation of FDG-PET/CT in imaging protocol improves selection of candidates for curative and palliative RT and allows further optimization of treatment management and therapy intention.
可靠的肿瘤分期是高效肿瘤治疗和进一步预后的基本前提。本研究的目的是比较 FDG-PET/CT 前后头颈部癌症（HNC）的分期，评估其对放疗（RT）计划的分期修改。
本回顾性研究共纳入 102 例未经治疗的原发性 HNC 患者，他们在 RT 前接受了常规分期和包括 FDG-PET/CT 的分期。将盲法的 FDG-PET/CT 分期数据与 FDG-PET/CT 后分期数据进行比较。通过比较 FDG-PET/CT 前后的治疗意图，测试其对患者管理的影响。
纳入 FDG-PET/CT 数据后，T、N 和 M 分期以及临床分期均发生显著改变（p = 0.002、0.0006、0.001、0.03，分别）。总体而言，FDG-PET/CT 的实施导致 14 例患者的 RT 意图决策发生改变。
FDG-PET/CT 对头颈部癌症患者的肿瘤分期有重要影响。在成像方案中实施 FDG-PET/CT 可改善适用于根治性和姑息性 RT 的患者选择，并允许进一步优化治疗管理和治疗意图。
