Niccoli Asabella Artor, Nappi Anna Giulia, Trani Orsola, Sardaro Angela, Rubini Giuseppe
Nuclear Medicine Unit, AOU Policlinic "A. Perrino", 72100 Brindisi, Italy.
Section of Nuclear Medicine, DIM, University "Aldo Moro", 70124 Bari, Italy.
Diagnostics (Basel). 2021 Feb 19;11(2):348. doi: 10.3390/diagnostics11020348.
Tonsillar carcinoma is the second most common malignancy of the head and neck region, with Squamous Cell Carcinoma (TSCC) as the most common histological type (>90%). For the advanced stage of TSCC, radiotherapy with or without platinum-based chemotherapy is the only therapeutic option. Immuno-checkpoint inhibitors (ICIs), in particular Nivolumab, considerably improves clinical management of these patients, but the response can be unpredictable. Difficulties can be encountered in evaluating response to immunotherapy, especially with morphological imaging, which can show an atypical response, such as pseudo-progression, leading to a premature discontinuation. Conversely, metabolic imaging can guide a more properly therapeutic decision. We present a case of a 71-year-old man affected by TSCC, treated with chemotherapy, radiotherapy, and Nivolumab as the last line of treatment. Pre- and post-immunotherapy F-FDG PET/CT showed an impressive response, avoiding early drug discontinuation and ensuring better management of this patient.
扁桃体癌是头颈部第二常见的恶性肿瘤，其中鳞状细胞癌（TSCC）是最常见的组织学类型（>90%）。对于晚期TSCC，放疗联合或不联合铂类化疗是唯一的治疗选择。免疫检查点抑制剂（ICIs），尤其是纳武单抗，显著改善了这些患者的临床治疗，但反应可能不可预测。评估免疫治疗反应可能会遇到困难，尤其是在形态学成像方面，其可能显示非典型反应，如假性进展，导致过早停药。相反，代谢成像可以指导更恰当的治疗决策。我们报告一例71岁男性TSCC患者，接受了化疗、放疗，并将纳武单抗作为最后一线治疗。免疫治疗前后的F-FDG PET/CT显示出显著反应，避免了过早停药，并确保了对该患者的更好管理。
