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II.
Application of PET/CT/MRI in Management of Head and Neck Cancer
Cheung PK, Chin RY, Eslick GD. Detecting residual/recurrent head neck squamous cell
carcinomas using PET or PET/CT: systematic review and meta-analysis.
Otolaryngol Head
Neck Surg
. 2016; 154(3):421-432. EBM level 2...............................................................22-33
Summary
: This paper looks at PET/CT for detecting residual/recurrent head and neck squamous cell
carcinoma. The study is a meta-analysis that found that PET/CT has high sensitivity and specificity.
Ryu IS, Roh JL, Kim JS, et al. Impact of
18
F-FDG PET/CT staging on management and
prognostic stratification in head and neck squamous cell carcinoma: a prospective
observational study.
Eur J Cancer
. 2016; 63:88-96. EBM level 2..................................34-42
Summary
: This paper prospectively examines how adding PET/CT to the work up of head and neck
squamous cell carcinoma patients affects management and prognosis. The authors found that PET/CT
changed the TNM stage in about one-third of patients, PET/CT work-up was more accurate than
conventional work up, and patients upstaged by PET/CT work-up had a worse prognosis.
Taghipour M, Sheikhbahaei S, Marashdeh W, et al. Use of
18
F-fludeoxyglucose-positron
emission tomography/computed tomography for patient management and outcome in
oropharyngeal squamous cell carcinoma: a review.
JAMA Otolaryngol Head Neck Surg
.
2016; 142(1):79-85. EBM level 3......................................................................................43-49
Summary
: This paper presents a literature on the use of PET/CT in oropharyngeal squamous cell
carcinoma.
III.
Complications: Dysphagia Prevention and Management After Therapy for Head and
Neck Cancer
Carnaby-Mann G, Crary MA, Schmalfuss I, Amdur R. “Pharyngocise”: randomized
controlled trial of preventative exercises to maintain muscle structure and swallowing
function during head-and-neck chemoradiotherapy.
Int J Radiat Oncol Biol Phys
. 2012;
83(1): 209-216. EBM level 1.............................................................................................50-59
Summary
: This is a randomized controlled trial of 58 patients undergoing chemoradiation therapy
(CRT) for head and neck cancer. Comparison groups were sham swallowing exercises, no exercises,
and intense swallowing therapy during treatment. As measured by clinical swallowing outcome and
by muscle bulk of the genioglossus and hyoglossus and mylohyoid muscles as determined by T2-
weighted MRI, the intense therapy group did much better and had reduced muscle atrophy relative to
the other groups. A short follow up, well-done study.
Peng KA, Kuan EC, Unger L, et al. A swallow preservation protocol improves function for
veterans receiving chemoradiation for head and neck cancer.
Otolaryngol Head Neck Surg
.
2015; 152(5): 863-867. EBM level 3.................................................................................60-64
Summary
: This is a retrospective study looking at all patients treated for head and neck cancer with
chemoradiation therapy (CRT) and comparing the swallowing outcomes of patients who were
compliant with swallowing therapy during treatment with those who were not compliant. Patients who
were not compliant with speech and swallowing exercises during and after treatment did worse than
patients who were compliant with regard to swallowing function as documented by FOSS scores in
these groups. This study demonstrates that swallow rehabilitation and exercise can improve functional
outcomes for patients receiving CRT or radiation therapy for head and neck cancer.