RTP On Demand — Head & Neck/Thyroid | Research To PracticePET-NECK: Utility of PET scanning in head and neck cancer after chemotherapy/radiation therapy for locally advanced nodal metastases
2:12 minutes.
TRANSCRIPTION:
DR LOVE: So a few imaging data sets that came out at ASCO, I wanted to ask you about one: PET-NECK, a multicenter, randomized Phase III controlled trial. DR COHEN: Yes. And again, when we step back and look at the fact that this study was even done, it’s really incredible. And again, commending the investigators for doing that. What the study asked was essentially a question that we face every single day in our clinics, and that is, does PET scan have utility in the setting after chemotherapy/radiation, or should we be doing elective neck dissections? Now, the elective neck dissection issue really isn’t something that we’re doing in practice very much. But the PET scan issue is certainly still controversial. And this was a study that was out of the United Kingdom. It was a randomized trial that compared either doing a PET scan and managing the neck based on the PET scan results or doing an elective neck dissection. And what they found was quite dramatic — that doing a PET scan had a very high negative predictive value, spared neck dissection in the great majority of patients and, in the abstract that followed the primary presentation, it was cost effective. So it actually reduced cost. And, of course, when we think of PET scanning, we think, “Oh. This is such an expensive test. Is it worth it?” When these investigators looked at that, it turned out to be definitely worth it. So I think now we can say, with prospective Phase III data, that PET scanning in that setting of the postchemotherapy/radiation does, in fact, have utility, does, in fact, lead to better outcomes, fewer operations and is actually cheaper. |