背景:在接受头颈癌治疗的患者中,影像学检查通常在治疗后3-6个月内进行,以评估治疗反应.六个月后,大多数指南提倡临床随访,保留用于临床可疑或模棱两可的患者的影像学检查。然而,一些指南确实建议进行系统的影像学监测,许多临床医生倾向于在他们的后续计划中包括某种类型的成像。
目的:本系统评价的重点是头颈部癌症治疗后常规(系统)影像学监测的有效性,超过了第一个3-6个月的基线影像学研究。
方法:使用PubMed和GoogleScholar进行了系统的文献检索。通过审查参考文献清单确定了其他研究。仅考虑原始研究和评论论文。将通过系统的治疗后监测成像获得的结果与症状导向成像和/或临床发现导向成像进行比较。
结果:通过数据库搜索确定了5121条记录,并通过其他来源确定了44条额外记录。选择了48篇文章进行最后审查。对这些记录的分析表明,几乎一半的局部复发和/或转移病例仅通过影像学检查发现(40.9%)。复发或转移性疾病的平均检测时间(11.5个月)远远超出了第一次治疗后扫描的时间.与其他成像技术相比,大多数作者报告了PET-CT的优越结果。
结论:在局部晚期头颈癌治疗后至少1年,优选2年,发现了支持系统影像学监测的有力论据。
■对选定记录的分析表明,几乎一半的局部复发和/或转移病例仅通过成像检测到。这项系统评价表明,目前在头颈部癌症患者的治疗后监测中,影像学可能未得到充分利用。
结论:•本系统综述重点关注长期系统影像学监测在头颈部癌症治疗患者中的有用性。•对521篇文章的分析显示,系统成像允许在超过40%的患者中初步检测到局部复发和/或转移。•目前,在晚期头颈部癌症患者的治疗后监测中,影像学可能未得到充分利用。
BACKGROUND: In patients treated for head and neck cancer, imaging studies are usually obtained within 3-6 months after treatment for assessment of treatment response. After 6 months, most guidelines advocate clinical follow-up, with imaging reserved for patients with clinically suspect or equivocal findings. However, some guidelines do recommend systematic imaging surveillance, and many clinicians tend to include some type of imaging in their follow-up schemes.
OBJECTIVE: This systematic
review focuses on the usefulness of routine (systematic) post-treatment imaging surveillance of head and neck cancer beyond the first 3-6-month baseline imaging study.
METHODS: A systematic literature search was conducted using PubMed and Google Scholar. Additional studies were identified by reviewing reference lists. Only original studies and
review papers were considered. Results obtained with systematic post-treatment surveillance imaging were compared to symptom-directed imaging and/or clinical finding-directed imaging.
RESULTS: Five hundred twenty-one records were identified through the database search, and 44 additional records were identified through other sources. Forty-eight articles were selected for the final
review. Analysis of these records showed that almost half of cases of locoregional recurrences and/or metastases were only detected by imaging (40.9%), and the mean time of detection of recurrent or metastatic disease (11.5 months) was well beyond the period of the first post-treatment scan. Most authors reported superior results with PET-CT when compared to other imaging techniques.
CONCLUSIONS: Strong arguments were found in favor of systematic imaging surveillance in locoregional advanced head and neck cancer during at least one and preferably 2 years after treatment.
UNASSIGNED: Analysis of the selected records showed that almost half of cases of locoregional recurrences and/or metastases were only detected by imaging. This systematic
review suggests that imaging may currently be underused in the post-treatment surveillance of patients with head and neck cancer.
CONCLUSIONS: • This systematic
review focuses on the usefulness of long-term systematic imaging surveillance in patients treated for head and neck cancer. • Analysis of 521 articles revealed that systematic imaging allowed the initial detection of locoregional recurrences and/or metastases in more than 40% of patients. • Imaging may currently be underused in the post-treatment surveillance of patients with advanced head and neck cancer.