Assessment of the therapeutic impact of a systematic use of PET-CT Scan with 18-FDG for the initial assessment of epidermoid carcinomas of the upper aero-digestive tract
Description
In order to assess the therapeutic impact of the use of PET-CT Scan with 18-FDG for the initial assessment of epidermoid carcinomas of the upper aero-digestive tract, data from a sample of 477 patients has been collected between 2004 and 2014. A conventional initial assessment (clinical examination, pan-endoscopy, CT scan and/or brain-face MRI and thorax CT scan) has been performed in association with PET-CT scan with 18-FDG, with a minimum follow-up over 3 years. The therapeutic impact has been classified according to three types: modification of staging and/or discovery of a synchronous cancer, modification of the surgical gesture or of the target volume in radiotherapy, or modification of the treatment type. Whereas 221 patients displayed a therapeutic impact, this one is discussed in terms of initial staging classification. It appears that the systematic performance of PET-CT scan during the initial assessment of epidermoid carcinomas should be envisaged whatever the stage be, as it results in a re-staging for one patient out of two, and in a treatment change for one patient out of five
Abstract (French)
L'objectif de l'etude etait d'evaluer l'impact therapeutique de la realisation de la TEP-TDM au 18-FDG dans le bilan d'extension initial des carcinomes epidermoides des VADS. De 2004 a 2014, 477 patients consecutifs ont beneficie d'un bilan initial conventionnel (examen clinique, pan-endoscopie, TDM et/ou IRM cervico-faciale et TDM thoracique) associe a une TEP-TDM au 18-FDG, avec un suivi minimal de 3 ans. L'impact therapeutique a ete classe en type 1 (modification de la stadification NM et/ou decouverte de cancer synchrone), type 2 (modification du geste chirurgical ou du volume cible en radiotherapie) ou type 3 (changement du type de traitement). Au total, 221 patients (46,3 %) ont eu un impact therapeutique quel qu'il soit, et 94 d'entre eux (19,5 %) ont eu un traitement different (modification de type 2 et 3). L'impact therapeutique de type 2 et 3 etait statistiquement equivalent entre les patients classes initialement en stade I/II et ceux en stade III/IV. Les patients en stade I/II en upstaging avaient une survie globale inferieure a ceux en staging identique. Chez les patients en stade III/IV, ceux en downstaging avaient une survie globale superieure par rapport aux autres. La realisation d'une TEP-TDM au 18-FDG systematique lors du bilan initial des carcinomes epidermoides devrait etre envisagee quel que soit le stade puisqu'elle permet un restaging chez un patient sur deux, et un changement de traitement chez un patient sur cinq. (auteur)
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Additional details
Additional titles
- Original title (French)
- Evaluation de l'impact therapeutique de la realisation systematique de la TEP-TDM au 18-FDG dans le bilan initial des carcinomes epidermoides des voies aero digestives superieures
Publishing Information
- Imprint Pagination
- 61 p.
- Report number
- FRNC-TH--13576
INIS
- Country of Publication
- France
- Country of Input or Organization
- France
- INIS RN
- 53119448
- Subject category
- S62: RADIOLOGY AND NUCLEAR MEDICINE;
- Resource subtype / Literary indicator
- Thesis
- Descriptors DEI
- CARCINOMAS; COMPARATIVE EVALUATIONS; DECISION MAKING; DIGESTIVE SYSTEM; EFFICIENCY; EPIDERMIS; FLUORINE 18; FLUORODEOXYGLUCOSE; NUCLEAR MEDICINE; ORAL CAVITY; PATIENTS; POSITRON COMPUTED TOMOGRAPHY; RESPIRATORY SYSTEM; TECHNOLOGY IMPACTS; THERAPEUTIC USES; TRACER TECHNIQUES
- Descriptors DEC
- ANIMAL TISSUES; ANTIMETABOLITES; BETA DECAY RADIOISOTOPES; BETA-PLUS DECAY RADIOISOTOPES; BODY; COMPUTERIZED TOMOGRAPHY; DIAGNOSTIC TECHNIQUES; DIGESTIVE SYSTEM; DISEASES; DRUGS; EMISSION COMPUTED TOMOGRAPHY; EPITHELIUM; EVALUATION; FLUORINE ISOTOPES; HOURS LIVING RADIOISOTOPES; ISOMERIC TRANSITION ISOTOPES; ISOTOPE APPLICATIONS; ISOTOPES; LIGHT NUCLEI; MEDICINE; NANOSECONDS LIVING RADIOISOTOPES; NEOPLASMS; NUCLEI; ODD-ODD NUCLEI; ORGANS; RADIOISOTOPES; SKIN; TOMOGRAPHY; USES
Optional Information
- Notes
- 33 refs.; Available from the INIS Liaison Officer for France, see the INIS website for current contact and E-mail addresses