Head and Neck Cancer Clinical Trial
Official title:
A Pilot Feasibility Study of PET-CT Imaging in Patients With Cancer of the Head and Neck Treated With Definitive Chemoradiation
RATIONALE: Imaging procedures, such as PET scan and CT scan, may help doctors predict a
patient's response to treatment and plan the best treatment.
PURPOSE: This clinical trial is studying how well PET scans and CT scans show response to
treatment in patients with locally advanced head and neck cancer undergoing chemotherapy and
radiation therapy.
OBJECTIVES:
Primary
- Determine the feasibility of performing positron emission tomography-computed
tomography (PET-CT) imaging for early discrimination of treatment response and
post-therapy neck management in patients with locally advanced cancer of the head and
neck treated with definitive chemoradiotherapy.
Secondary
- Perform semiquantitative analysis of tracer uptake in these patients using standard
uptake values and qualitative analysis of tracer uptake using pure visual analysis.
- Determine the feasibility of distinguishing benign from malignant processes during
initial tumor staging of these patients by whole-body PET-CT imaging.
- Correlate staging by whole-body PET-CT imaging with staging by standard CT/MRI,
clinical exam, and pathologic specimen.
- Determine the feasibility of PET-CT imaging in these patients in treatment position for
radiotherapy treatment planning, correlate the results with standard CT/MRI images, and
record the differences.
- Perform PET-CT imaging in these patients during weeks 2 and 4 of chemoradiotherapy to
evaluate the predictive value of response to treatment at these time points.
- Determine if the time interval for treatment monitoring at 6 and 12 weeks post
chemoradiotherapy is important for the predictive value of PET-CT imaging.
- Evaluate patients with clinical or radiographic abnormalities worrisome for residual or
recurrent disease with PET-CT imaging at 6 and 12 weeks post chemoradiotherapy to
assess the need for additional therapies (i.e., neck dissection).
OUTLINE: This is a pilot study.
Patients receive fludeoxyglucose F 18 (FDG) IV over 90 seconds prior to the initial scan.
Patients undergo whole-body computed tomography (CT) imaging with contrast followed by
positron emission tomography (PET) imaging (approximately 1 hour after FDG injection) for
initial staging and simulation for radiotherapy treatment planning. After PET-CT evaluation,
patients with locoregional disease are recommended for standard-care chemoradiotherapy.
Patients with evidence of M1 disease that is confirmed by CT/MRI and/or biopsy are treated
at the discretion of the attending clinician. During chemoradiotherapy, patients undergo
PET-CT imaging, as described above, at the beginning of week 2 and during week 4 for
treatment monitoring and early detection of recurrent or residual disease. Follow-up PET-CT
scans are performed, as described previously, at 6 weeks and then at 3 months after
completion of chemoradiotherapy.
After completion of study procedures, patients are followed periodically for up to 5 years.
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