Treatment response in the neck: p16+ versus p16− oropharyngeal cancer. Issue 3 (30th January 2013)

• Record Type: Journal Article
• Authors: Mak, Daisy; Hicks, Rodney J; Rischin, Danny; Solomon, Ben; Peters, Lester; Bressel, Mathias; Young, Richard J; Corry, June
• Is Part Of: Journal of medical imaging and radiation oncology. Volume 57:Issue 3(2013:Jun.)
• Page Start: 364
• Page End: 372
• Publication Date: 2013-01-30
• Subjects: Radiology, Medical -- Periodicals; Radiology, Medical -- Australasia -- Periodicals; 616.0757
• DOI: 10.1111/1754-9485.12024
• Languages: English
• ISSNs: 1754-9477

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jmiro12024-sec-0001" sec-type="section"> <title>Introduction</title> <p>To compare nodal response rates following chemoradiotherapy in patients with p16+ and p16− oropharyngeal squamous cell carcinoma (OPSCC).</p> </sec> <sec id="jmiro12024-sec-0002" sec-type="section"> <title>Methods</title> <p>Patients with node‐positive OPSCC treated at Peter MacCallum Cancer Centre on the published phase I–III tirapazamine trials were identified. All patients had conventional assessment (clinical examination (CA), CT and/or MRI) and positron emission tomography (PET) at both baseline and 2–4 months post‐treatment.</p> </sec> <sec id="jmiro12024-sec-0003" sec-type="section"> <title>Results</title> <p>There were 30 p16+ and 18 p16− patients, the former group having significantly higher stage nodal disease (<italic>P</italic> = 0.016). The mean overall reduction in nodal size at post‐treatment assessment was similar in p16+ and p16− patients (78% vs. 75%), and no statistically significant difference in nodal complete response (CR) rates was detected by either CA (50% vs. 39%, <italic>P</italic> = 0.35) or PET/PET‐CT (93% vs. 83%, <italic>P</italic> = 0.19). PET was significantly more accurate in determining the true nodal CR rate in both groups, with a negative predictive value of 96%.</p> </sec> <sec id="jmiro12024-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Nodal response rates following chemoradiotherapy appear to be similar in p16+ and p16− patients when assessed by either CA or PET/PET‐CT. However, higher nodal CR was seen in PET/PET‐CT compared with CA in both groups. Metabolic imaging is more accurate than CA in assessing nodal response post‐treatment.</p> </sec> </abstract>