Is F-18 FDG PET/computed tomography a useful tool to restage the patients with tongue carcinoma?

OBJECTIVE: The aim of this study was to evaluate the diagnostic performance of contrast-enhanced F-18 fluoro-2-deoxyglucose (F-18 FDG) PET/computed tomography (CT) in restaging of tongue carcinoma. MATERIAL AND METHODS: Retrospectively analysis of carcinoma tongue patients (n = 110) who were treated and referred for FDG PET/CT. Histopathological examination and clinical or imaging follow-up were taken as gold standard. RESULTS: Of 110 patients, FDG PET/CT detected FDG avid lesions in 69 (62.7%) patients. Sensitivity, specificity and diagnostic accuracy of FDG PET/CT were 92.9%, 90.0% and 91.8%, respectively, for residual/recurrence disease detection (P < 0.05). Additionally, in six patients, metachronous primaries were also detected [lung (4), esophagus and lymphoma (1) each]. The mean maximum standardized uptake value (SUVmax) with 95% confidence interval for primary site recurrence, regional lymph nodes and metastatic lesions was 11.51 (9.53-13.48), 69 (62.7%) (7.88-11.48) and 8.94 (3.11-14.76), respectively. CONCLUSION: FDG PET/CT demonstrates high diagnostic accuracy for detection of residual/recurrent disease in treated tongue cancer patients and PET/CT should be considered as first-line diagnostic investigation in these patients.

A Bidirectional Observational Study of Concomitant Chemo-Radiotherapy in Adenocarcinoma Stomach.

BACKGROUND: Although many cancers have seen a significant improvement in survival and reduction in morbidity in the past few decades, the same cannot be said about adenocarcinoma stomach. Upfront surgery in non metastatic stomach cancers definitely improves survival. It is well established that any form of adjuvant therapy adds to the improvement in survival, controversy remains if adjuvant chemoradiotherapy is the standard or not. METHODOLOGY: This study is a single arm bidirectional observational study of the stomach cancer patients undergoing adjuvant concurrent chemoradiotherapy with 5 FU (5 Fluorouracil) with an aim to estimate the disease free survival (DFS) and to analyze toxicity patterns. A total of 73 patients with stomach cancer undergoing gastric resection with a curative intent were evaluated. RESULTS: With a median follow up of 16 months, the estimated disease free survival is 31.6 months. Of the 73 patients, recurrences were observed in 33 patients and the most common site was liver metastasis. Except for 2 patients, out of which one expired because of 5 FU induced myocardial infarction and another expired because of neutropenic sepsis during the first cycle of chemotherapy, most of the patients tolerated the regimen well. CONCLUSION: 5 FU based adjuvant CT-RT can be safely given in the Indian population with acceptable survival rates.