Back to Search
Start Over
The Effects of Human Papillomavirus Status and Treatment on the Positive Predictive Value of Post-radiotherapy 18 F-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography in Advanced Head and Neck Squamous Cell Carcinoma.
- Source :
-
Clinical oncology (Royal College of Radiologists (Great Britain)) [Clin Oncol (R Coll Radiol)] 2023 Dec; Vol. 35 (12), pp. e699-e707. Date of Electronic Publication: 2023 Sep 22. - Publication Year :
- 2023
-
Abstract
- Aims: The high negative predictive value of post-chemoradiation (CRT) positron emission tomography-computed tomography (PET-CT) is well established in head and neck squamous cell cancers (HNSCC). The positive predictive value (PPV) remains under scrutiny, with increasing evidence that it is affected by several factors. The aim of this study was to assess the PPV of post-treatment PET-CT for residual nodal disease when stratified by treatment modality and tumour human papillomavirus (HPV) status.<br />Materials and Methods: This was a retrospective cohort study in a tertiary oncology centre carried out between January 2013 and December 2019. Patients were radically treated with radiotherapy only/CRT for node-positive HNSCC. PET-CT nodal responses were categorised as complete, equivocal (EQR) or incomplete (ICR), and outcomes extracted from electronic records.<br />Results: In total, 480 patients were evaluated, all had a minimum potential follow-up of 2 years, with a median of 39.2 months. The PPV of 12-week PET-CT was significantly different between HPV-positive (22.5%) and HPV-unrelated (52.7%) disease, P < 0.001. It was also significantly different between the CRT (24.8%) and radiotherapy-only (51.1%) groups, P = 0.001. The PPV of an EQR was significantly less than an ICR, irrespective of HPV status and primary treatment modality. In HPV-positive disease, the PPV of an EQR was 9.0% for the CRT group compared with 21.4% for radiotherapy only, P = 0.278. The PPV in those who achieved an ICR was 34.2% in the CRT group, significantly lower than 70.0% in the radiotherapy-only group, P = 0.03.<br />Conclusion: The PPV of 12-week PET-CT is significantly lower for HPV-positive compared with HPV-unrelated HNSCC. It is poorer in patients with HPV-positive disease treated with CRT compared with radiotherapy alone.<br /> (Copyright © 2023. Published by Elsevier Ltd.)
- Subjects :
- Humans
Squamous Cell Carcinoma of Head and Neck diagnostic imaging
Squamous Cell Carcinoma of Head and Neck radiotherapy
Positron Emission Tomography Computed Tomography methods
Fluorodeoxyglucose F18
Predictive Value of Tests
Human Papillomavirus Viruses
Retrospective Studies
Head and Neck Neoplasms diagnostic imaging
Head and Neck Neoplasms radiotherapy
Papillomavirus Infections diagnostic imaging
Papillomavirus Infections radiotherapy
Subjects
Details
- Language :
- English
- ISSN :
- 1433-2981
- Volume :
- 35
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Clinical oncology (Royal College of Radiologists (Great Britain))
- Publication Type :
- Academic Journal
- Accession number :
- 37798198
- Full Text :
- https://doi.org/10.1016/j.clon.2023.09.006