1. Post-operative PET/CT improves the detection of early recurrence of squamous cell carcinomas of the oral cavity.
- Author
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Yu Y, Schöder H, Zakeri K, Chen L, Kang JJ, McBride SM, Tsai CJ, Gelblum DY, Boyle JO, Cracchiolo JR, Cohen MA, Singh B, Ganly I, Patel SG, Michel LS, Dunn L, Sherman EJ, Pfister DG, Wong RJ, Riaz N, and Lee NY
- Subjects
- Humans, Positron Emission Tomography Computed Tomography methods, Retrospective Studies, Squamous Cell Carcinoma of Head and Neck, Fluorodeoxyglucose F18, Positron-Emission Tomography methods, Carcinoma, Squamous Cell diagnostic imaging, Carcinoma, Squamous Cell surgery, Mouth Neoplasms diagnostic imaging, Mouth Neoplasms surgery, Head and Neck Neoplasms
- Abstract
Background: We evaluate the impact of post-operative 18-fluorodeoxyglucose positron emission tomography with computed tomography (PET/CT) for radiation planning on the detection of early recurrence (ER) and treatment outcomes in oral squamous cell carcinoma (OSCC)., Methods: We retrospectively reviewed the records of patients treated with post-operative radiation between 2005 and 2019 for OSCC at our institution. Extracapsular extension and positive surgical margins were classified as high risk features; pT3-4, node positivity, lymphovascular invasion, perineural invasion, tumor thickness >5 mm, and close surgical margins were considered intermediate risk features. Patients with ER were identified. Inverse probability of treatment weighting (IPTW) was used to adjust for imbalances between baseline characteristics., Results: 391 patients with OSCC were treated with post-operative radiation. 237 (60.6%) patients underwent post-operative PET/CT planning vs. 154 (39.4%) who were planned with CT only. Patients screened with post-operative PET/CT were more likely to be diagnosed with ER than those planned with CT only (16.5 vs. 3.3%, p < 0.0001). Among patients with ER, those with intermediate features were more likely than those high risk features to undergo major treatment intensification, including re-operation, the addition of chemotherapy, or intensification of radiation by ≥ 10 Gy (91% vs. 9%, p < 0.0001). Post-operative PET/CT was associated with improved disease-free and overall survival for patients with intermediate risk features (IPTW log-rank p = 0.026 and p = 0.047, respectively) but not high risk features (IPTW log-rank p = 0.44 and p = 0.96)., Conclusions: Use of post-operative PET/CT is associated with increased detection of early recurrence. Among patients with intermediate risk features, this may translate to improved disease-free survival., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Yao Yu: Travel: Elekta. Heiko Schoder: None. Kaveh Zakeri: None. Linda Chen: None. Jung Kang: None. Sean McBride: Consulting or Advisory: Janssen, Astra Zeneca; Research Funding: Genentech, AstraZeneca. C. Jillian Tsai: Honoraria: Varian Medical Inc; Consulting or Advisory: Varian Medical Systems. Daphna Gelblum: None. Jay Boyle: None. Jennifer R Cracchiolo: None. Marc A Cohen: None. Bhuvanesh Singh: None. Ian Ganly: None. Snehal Patel: Patent PCT/US2016/026717; equity in Summit Biomedical Imaging; patent US 10,016,238 B2 Apparatus; equity in ColdSteel Laser Inc; patent PCT/US2014/073053; patent PCT/US2015/065816 ; Patent PCT/US2016/066969. Loren Michel: Research Funding: Exelixis; Travel: Immunomedics. Lara Dunn: Consulting: Regeneron, CUE Biopharma, Merck; Research Funding: Regeneron, Eisai, CUE-101. Eric Sherman: Consulting: Cota Healthcare, Goldilocks, Eisai, Regeneron, UpToDate, Lilly, Blueprint Medicines; Research Funding: Plexxikon, Regeneron. David Pfister: Consulting or Advisory: Boehringer Ingelheim, Incyte; Research Funding: AstraZeneca, Atara Biotherapeutics, Bayer, Boehringer Ingelheim, Eisai, Exelixis, Genentech/Roche, Hoopika Pharma, Lilly, Medimmune, MeiraGtx, Merck, Novartis, Regeneron. Richard Wong: None. Nadeem Riaz: Honoraria: PeerView; Consulting or Advisory: Mirati Therapeutics, Repare Therapeutics; Speakers Bureau: Illumina; Research Funding: Bristol Myers Squibb, Pfizer, Repare Therapeutics; Travel, Accommodations, Expenses: Varian Medical Systems. Nancy Lee: Consulting or Advisory: Merck, Pfizer, Merck Serono, Sanofi, Mirati Therapeutics, Roche/Genentech; Research Funding: AstraZeneca, Pfizer., (Copyright © 2023 Elsevier Ltd. All rights reserved.)
- Published
- 2023
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