18F-Fdg-PET-guided Planning and Re-Planning (Adaptive) Radiotherapy in Head and Neck Cancer: Current State of Art

Anticancer Res. 2017 Dec;37(12):6523-6532. doi: 10.21873/anticanres.12108.

Abstract

Background/aim: A review of the literature is proposed as a contribution to current knowledge on technical, physical, and clinical issues about PET-guided planning and re-planning radiotherapy (RT) in head and neck cancer.

Materials and methods: PubMed and Scopus electronic databases were searched for articles including clinical trials. Search terms were "gross tumor volume (GTV) delineation", "head and neck cancer", "radiotherapy", "adaptive radiotherapy" in combination with "PET".

Results: A 18F-FDG-PET and CT-scan comparison in GTV definition for RT planning of head and neck cancer was shown in twenty-seven clinical trials with a total of 712 patients. Only two clinical trials focused on PET-guided adaptive radiotherapy (ART) with a total of 31 patients.

Conclusion: 18F-FDG-PET is able to achieve an accurate and precise definition of GTV boundaries during RT planning, especially in combination with CT-scan. ART strategies are proposed to evaluate tumor volume changes, plan boost irradiation on metabolically active residual neoplasm and protect organs at risk (OaRs).

Keywords: 18F-FDG PET; Adaptive radiotherapy; head and neck cancer; review; target definition.

Publication types

  • Review

MeSH terms

  • Fluorodeoxyglucose F18*
  • Head and Neck Neoplasms / diagnostic imaging*
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / radiotherapy*
  • Humans
  • Positron-Emission Tomography / methods*
  • Radiotherapy Planning, Computer-Assisted / methods*
  • Tomography, X-Ray Computed / methods
  • Tumor Burden / radiation effects

Substances

  • Fluorodeoxyglucose F18