Safety and cost analysis of an (18)FDG-PET-CT response based follow-up strategy for head and neck cancers treated with primary radiation or chemoradiation

Oral Oncology
Ketan ShahJune Corry

Abstract

Prognostic information can rationalise clinical follow-up after radical cancer treatment. This retrospective cohort study of radical head and neck (chemo)radiotherapy patients examines the clinical safety and cost implications of stratifying follow-up intensity by post-treatment (18)FDG-PET-CT response. In 2008 clinical review after radical head and neck radiotherapy was reduced from 3- to 6-monthly for patients with complete (18)FDG-PET-CT response at 3months. 184 patients treated after this change ("PET Stratified", 2009-11) were compared to 178 patients treated before ("Standard", 2005-7). Clinical safety was assessed by the time to detection of recurrence, overall survival and potential for radical treatment of recurrence. A hospital cost analysis was performed using individual patient data. 127 of 178 Standard and 148 of 184 PET Stratified patients achieved complete response on post-treatment imaging. Baseline clinical characteristics were comparable. Median follow-up from response assessment was 4.8years in the Standard cohort and 2.1years for PET Stratified. PET Stratified patients had a mean 4.4 outpatient visits in 2years, compared to 7.0 among Standard patients. Over 90% of patients remained free of recurrence at 2yea...Continue Reading

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Citations

Nov 4, 2015·The British Journal of Radiology·Wei LeiJian-An Huang
Aug 16, 2016·The New England Journal of Medicine·Hisham MehannaJanet Dunn
Jun 25, 2016·Clinical and Experimental Otorhinolaryngology·Nerina DenaroElvio Grazioso Russi
Jul 29, 2015·CA: a Cancer Journal for Clinicians·Angela C ChiBrad W Neville
Aug 16, 2016·The New England Journal of Medicine·Caleb DulaneyJames Bonner

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