Research

PET/CT Staging Followed by Intensity-Modulated Radiotherapy (IMRT) Improves Treatment Outcome of Locally Advanced Pharyngeal Carcinoma: a matched-pair comparison

Sacha Rothschild^1,2 , Gabriela Studer¹ , Burkhardt Seifert³ , Pia Huguenin⁴ , Christoph Glanzmann¹ , J Bernard Davis¹ , Urs M Lütolf¹ , Thomas F Hany⁵ and I Frank Ciernik^6,7

¹  Radiation Oncology, Zurich University Hospital, Rämistrasse 100, 8091, Zurich, Switzerland

²  Medical Oncology, Kantonsspital Aarau, Tellstrasse, 5001, Aarau, Switzerland

³  Institute for Social- and Preventive Medicine, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland

⁴  Radiation Oncology, Kantonsspital Graubünden, Loëstrasse 107, 7000 Chur, Switzerland

⁵  Nuclear Medicine, Zurich University Hospital, Rämistrasse 100, 8091, Zurich, Switzerland

⁶  Center for Clinical Research, Zurich University Hospital, Rämistrasse 100, 8091, Zurich, Switzerland

⁷  Oncology Institute of Southern Switzerland, Ospedale San Giovanni e Valli, 6500 Bellinzona, Switzerland

author email corresponding author email

Radiation Oncology 2007, 2:22doi:10.1186/1748-717X-2-22

Published:	9 June 2007

Abstract

Background

Impact of non-pharmacological innovations on cancer cure rates is difficult to assess. It remains unclear, whether outcome improves with 2- [18-F]-fluoro-2-deoxyglucose-positron emission tomography and integrated computer tomography (PET/CT) and intensity-modulated radiotherapy (IMRT) for curative treatment of advanced pharyngeal carcinoma.

Patients and methods

Forty five patients with stage IVA oro- or hypopharyngeal carcinoma were staged with an integrated PET/CT and treated with definitive chemoradiation with IMRT from 2002 until 2005. To estimate the impact of PET/CT with IMRT on outcome, a case-control analysis on all patients with PET/CT and IMRT was done after matching with eighty six patients treated between 1991 and 2001 without PET/CT and 3D-conformal radiotherapy with respect to gender, age, stage, grade, and tumor location with a ratio of 1:2. Median follow-up was eighteen months (range, 6–49 months) for the PET/CT-IMRT group and twenty eight months (range, 1–168 months) for the controls.

Results

PET/CT and treatment with IMRT improved cure rates compared to patients without PET/CT and IMRT. Overall survival of patients with PET/CT and IMRT was 97% and 91% at 1 and 2 years respectively, compared to 74% and 54% for patients without PET/CT or IMRT (p = 0.002). The event-free survival rate of PET/CT-IMRT group was 90% and 80% at 1 and 2 years respectively, compared to 72% and 56% in the control group (p = 0.005).

Conclusion

PET/CT in combination with IMRT and chemotherapy for pharyngeal carcinoma improve oncological therapy of pharyngeal carcinomas. Long-term follow-up is needed to confirm these findings.