Survival rates among head and neck cancer (HNC) patients were similar for those whose treatment surveillance was guided by PET/CT and those with planned neck dissections, but PET/CT resulted in fewer surgeries following treatment and was more cost-effective in a recent study, published in the New England Journal of Medicine.
The study included more than 560 patients in the U.K. who underwent chemoradiotherapy for advanced nodal stage head and neck cancer (NEJM, March 23, 2016). Researchers randomly divided the cohort in two groups: patients who received a scheduled neck dissection following treatment, which served as a control group, and patients who underwent PET/CT 12 weeks after they completed chemoradiotherapy and served as the experimental surveillance group.
After undergoing PET/CT scans, patients in the surveillance group subsequently underwent neck dissection only if they had an incomplete or equivocal nodal response after treatment. All other results were deemed complete responses to therapy.
The researchers found fewer surgical interventions in the group that underwent PET/CT imaging. There were 54 neck dissections (19%) performed within the PET/CT-guided surveillance cohort, compared with 221 such procedures (78%) in the group scheduled for neck dissection. They also found that quality of life and survival rates were similar between the two patient groups. However, the group that underwent PET/CT saved an average of 1,492 pounds ($2,190) more per person than the dissection group.
"Survival was similar among patients who underwent PET/CT-guided surveillance and those who underwent planned neck dissection, but surveillance resulted in considerably fewer operations, and it was more cost-effective," the researchers concluded.
