pet -flt monitoring of therapy response in head and neck cancer

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Juan Carlos Mazabuel Quintero R3 Radioterapia

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Page 1: PET -FLT Monitoring of therapy response in Head and Neck Cancer

Juan Carlos Mazabuel Quintero

R3 Radioterapia

Page 2: PET -FLT Monitoring of therapy response in Head and Neck Cancer

INDICE

JUSTIFICACIÓN

GENERALIDADES

ESTUDIOS

CONCLUSIONES

DISCUSION

BIBLIOGRAFIA

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GENERALIDADES Tumores de C y C representan el 5-7% de los TM.

Tasa de incidencia estandarizada de 20,1 en hombres y 3,1 en mujeres x 100.000 Hab.

Según la IARC anualmente se diagnostican 634.760 casos y fallecen 356.705 pacientes .

El 95% son de tipo Escamoso . 1/3 se presentan es estadios precoces (T1-T2 ) y 2/3 en estadios avanzados (T3-T4 , N1-N3 ) .

Según CNE para 2012 en España estos tumores causaron 5.397 defunciones = 4.743 h. y 654 m.

Según EUROCARE la supervivencia estimada a 5 años es del 49,5% .

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METABOLISMO DE FDG

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FALSE – POSITIVE PET/CT

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TRUE – NEGATIVE PET / CT

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TRUE – POSITIVE PET/CT

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Suggested algorithm for management of HNSCC

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RADIOFARMACOS EN ESTUDIO

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CONCLUSIONES El PET - CT /FDG es muy útil para detectar enfermedad residual o recurrente en

cáncer de cabeza y cuello con S : 94% y E: 82% .

Un PET -CT /FDG Negativo es altamente predictivo de ausencia de enfermedad , con un VPN : 95% .

Con un PET-CT /FDG negativo puede potencialmente obviarse una disección planeada de cuello y/o una endoscopia de vigilancia .

La sensibilidad del PET-CT / FDG es baja en las 10 semanas pos-tratamiento .

En cáncer de C y C cambios tempranos en la captación del PET-CT / FLT durante la QT-RT . Es un fuerte predictor de resultado a largo tiempo.

El PET-CT / FLT puede ayudar a la modificicación de tratamientos QT-RT durante la fase temprana de evaluación.

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