Steven James Sherry BS, Presenter: Nothing to Disclose

Andrew Thomas Colucci BA, Abstract Co-Author: Nothing to Disclose

Mary Zoccoli MD, Abstract Co-Author: Nothing to Disclose

Al Ozonoff PhD, Abstract Co-Author: Nothing to Disclose

Minh Tam Truong MD, Abstract Co-Author: Nothing to Disclose

Rathan Markandan Subramaniam MD, Abstract Co-Author: Research support, General Electric Company

Jon Adams, Abstract Co-Author: Nothing to Disclose

00030490-DMT et al, Abstract Co-Author: Nothing to Disclose

To determine the outcome of patients with a negative FDG PET/CT, following successful therapy for advanced head and neck squamous cell carcinoma (HNSCC), by evaluating the progression-free survival.

An institutional review board approved a HIPPA-compliant retrospective chart analysis of 105 patients with HNSCC who received treatment between August 2004 and March 2008. To date, only 32 patients have had newly-diagnosed, biopsy-proven HNSCC, were > 18 years of age, had no prior head and neck malignancy, had post-treatment FDG PET/CT demonstrating successful therapy. If a patient had a history of non-HNSCC, patients must have been disease-free for 3 years. The data collected included: demographics (age, gender, ethnicity), risk factors (smoking history / HPV status), procedure dates and results (PET/CT imaging / biopsy results), primary foci, initial staging, treatment type (chemoradiotherapy, surgery or other), and date of progression. The end points of the study include analysis of progression-free survival using incidence rate and Kaplan-Meier estimator analysis demonstrating the NPV of FDG PET/CT on HNSCC recurrence.

The trial consisted of 24 males and 8 females, 4 patients of Asian descent, 6 of African American, 1 of Hispanic origin, and 21 of Caucasian. Patients without progression were of 55 years, median (standard deviation 11.1 years, n=27). The greatest HNSCC incidence by site were 12 oropharyngeal and 6 glottic, epiglottic or supraglottic foci. All 3 cases with progression had oropharyngeal foci and had nodal involvement. The median age of patients with progression was 59 years (standard deviation 6 years, n=3). The incidence rate for HNSCC recurrence is 3/32 = 9.4% (95% CI 2.5-26.2%) within the median follow-up period of 12.2 months (range 0.9-31.7 months). Kaplan-Meier analysis indicates that the progression-free survival rate is 88.7% (95% CI 71.4-96.1%, n=32). However, when 110 patients are analyzed, a confidence interval of +/- 5.5% should bound the incidence rate of HNSCC progression.

Preliminary results are presented only for 32 patients (of 110 total patients) examined to date. Greater than 90% of patients with post-therapy complete FDG PET/CT response demonstrate progression-free survival at 6 months.

Advanced HNSCC patients with a complete PET/CT response following curative chemoradiation therapy demonstrate good progression-free survival.

Sherry, S, Colucci, A, Zoccoli, M, Ozonoff, A, Truong, M, Subramaniam, R, Adams, J, et al, 0, The Value of FDG PET/CT in the Management of Patients after Treatment for Advanced HNSCC.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8002427.html