Department of Radiology, Anschutz Medical Campus, University of Colorado, Aurora, Colorado.
University of Colorado Cancer Center, Anschutz Medical Campus, University of Colorado, Aurora, Colorado.
Cancer. 2021 Feb 15;127(4):535-543. doi: 10.1002/cncr.33244. Epub 2020 Oct 29.
Persistent controversy exists with regard to how and when patients with head and neck cancer should undergo imaging after definitive therapy. The current study was conducted to evaluate whether the type of imaging modality used in posttreatment imaging impacts cancer-specific survival for patients with advanced head and neck squamous cell carcinoma.
A retrospective study of National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) program-Medicare-linked data in patients with an advanced stage of the 3 most common head and neck malignancies (oral cavity, oropharynx, and larynx) was conducted. Hazard ratios and 95% CIs for cancer-specific survival were estimated for patients diagnosed with any of these cancers between 2006 and 2015.
Significant improvement with regard to cancer-specific survival was observed among patients with American Joint Committee on Cancer stage III and stage IVA laryngeal cancer who underwent positron emission tomography (PET) and/or computed tomography (CT) imaging during the first 6 months after receipt of definitive treatment (hazard ratio, 0.517; 95% CI, 0.33-0.811) compared with those who underwent CT. There was a trend toward an improvement in cancer-specific survival among patients with oral cavity or oropharyngeal malignancies who underwent PET/CT imaging, but it did not reach statistical significance.
Compared with CT imaging, posttreatment imaging with PET was associated with improved survival in patients with advanced laryngeal carcinoma.
关于头颈部癌症患者在根治性治疗后应如何以及何时进行影像学检查，一直存在争议。本研究旨在评估治疗后影像学检查中使用的影像学方式是否会影响晚期头颈部鳞状细胞癌患者的癌症特异性生存。
对国家癌症研究所监测、流行病学和最终结果（SEER）计划-医疗保险相关数据中晚期（口腔、口咽和喉）3 种最常见头颈部恶性肿瘤患者进行回顾性研究。对 2006 年至 2015 年间诊断出患有这些癌症之一的患者进行癌症特异性生存的风险比和 95%置信区间估计。
与接受 CT 检查的患者相比，接受正电子发射断层扫描（PET）和/或计算机断层扫描（CT）检查的 III 期和 IVA 期喉癌患者的癌症特异性生存显著改善（风险比，0.517；95%CI，0.33-0.811）。口腔或口咽恶性肿瘤患者行 PET/CT 检查后，癌症特异性生存有改善趋势，但未达到统计学意义。
与 CT 成像相比，晚期喉癌患者的治疗后 PET 成像与生存改善相关。
