ADVANCED SQUAMOUS CELL CARCINOMA OF THE OROPHARYNX: EFFICACY OF POSITRON EMISSION

Background. To evaluate the efficacy of fluorine- 18-fluorodeoxyglucose emission tomography (FDG-PET) and CT versus endoscopy with biopsy under general anesthesia for estimating tumor volume reduction among patients treated with induction chemotherapy for advanced squamous cell carcinoma (SCC) of the oropharynx. Methods. Twelve patients with oropharyngeal SCC nested in a phase II, induction chemoradiation, organ preservation trial (University of Michigan Cancer Center 9921) underwent tumor volume reduction estimation as assessed by FDG-PET, CT, and endoscopy with biopsy. Results. In 9 of 12 patients, FDG-PET, CT, and endoscopy demonstrated agreement in estimation of tumor reduction. Two patients had discordant results, whereas 1 patient was inad- equately evaluated with FDG-PET. The kappa value for PET ver- sus endoscopy was 0.62, which is categorized as substantial agreement. The kappa value for CT versus endoscopy was 0.40, which is categorized as fair agreement. Conclusion. FDG-PET may be as efficacious as endoscopy with biopsy under general anesthesia for estimating tumor vol- ume reduction with induction chemotherapy. V C 2009 Wiley Periodicals, Inc. Head Neck 31: 452-460, 2009