90% of head and neck cancers are squamous cell carcinomas, known as head and neck squamous cell carcinomas (HNSCC). HSNCC is the sixth leading cancer by incidence across the globe, with an estimated 500,000 new cases reported each year.
The study published in the New England Journal of Medicine, used advanced imaging to identify cancer cells still present after treatment of head and neck cancer with primary chemoradiotherapy.
Previous guidelines meant that all head and neck cancer patients have to undergo neck dissection surgery, a three-hour operation with considerable morbidity and up to a one week hospital stay, because there was no reliable way to identify which patients still had remaining cancer cells.
The use of positron emission tomography-computed tomography (PET-CT) scans for image-guided surveillance meant that routine post-treatment operations were no longer necessary, and can now be better targeted to the right areas in those 20% of patients who still have persistent cancer.
The study was conducted across 37 centres in the UK, overseen by Warwick Clinical Trials Unit, University of Warwick. 564 patients were recruited between 2007 and 2012, with 282 in the image-guided surveillance group and 282 in the neck dissection control group.
Only 54 (19%) of the 282 in the image-guided surveillance group went on to undergo neck dissection surgery, compared with 221(78%) of the 282 in the control group.
Survival rates, quality of life and other factors were considered and remained similar across both groups. The results show that the use of PET-CT imaging can prevent unnecessary operations and reduce associated surgical complications.
New imaging scans track down persistent cancer cells
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