Routine follow-up scans can detect head and neck cancer recurrences earlier

Routine use of positron emission tomography/computed tomography (PET/CT) scans in head and neck cancer patient follow-up can detect local recurrences before they become clinically apparent and may improve the outcome of subsequent salvage therapy, according to a study presented at the Multidisciplinary Head and Neck Cancer Symposium.

PET scan is a relatively new test and its use as a routine follow up for head and neck cancer patients is controversial. Most head and neck cancer follow-up studies use Fluorodeoxyglucose-PET (FDG-PET) scans when recurrence is suspected, but few studies have been conducted to determine the value of PET scans in fixed intervals post-treatment.

Researchers in this study reviewed 234 head and neck cancer cases treated with chemoradiation between 2006 and 2010 that also had a post-therapy PET/CT scan. The scans identified 15 patients with abnormalities requiring further evaluation, and biopsies showed malignancies in eight of the 15 cases. The other seven cases were false positives.

All of the patients who had negative PET/CT scans remained disease free in subsequent follow-ups.

"With malignancies found in 53 percent of abnormal scans in this study, our research proves that PET/CT scans are valuable as routine follow-up and as a surveillance method for head and neck cancer patients," Yasir Rudha, MD, MBChB, lead author of the study and a researcher at St. John Hospital/Van elslander Cancer Center in Grosse Pointe Woods, Mich., said. "However, since the rate of false positives was 46 percent, caution should be shown when ordering biopsies after abnormal scans to prevent excessive unnecessary biopsies."