Mid-treatment imaging useful for de-escalating therapy for oropharynx cancer

"Advanced imaging helps physicians personalize therapy based on patients' individual tumor characteristics and response to treatment. By incorporating FDG-PET scans before and midway through treatment, we were able to adjust the radiation dose for about half of our patients and reduce their short-term side effects while still focusing on tumor control," said lead author Steven Allen, MD, PhD, a radiation oncology resident at the University of Michigan.

Half of the patients met de-escalation criteria and received the lower radiation dose, resulting in approximately 25% less radiation exposure to the sensitive structures in the head and neck known to be associated with side effects during treatment. Patients in the de-escalated group had significantly less weight loss during treatment (6% vs. 11% from baseline, p<0.001), were less likely to need a feeding tube (1 vs. 7 patients, p=0.037) and had improved swallowing function on a video swallow study administered after treatment (p=0.036).

"We anticipated long-term improvements in side effects, but the short-term improvements were better than expected," said senior author and principal investigator Michelle L Mierzwa, MD, Associate Chair of Clinical Research and Co-Chair of Head and Neck Clinical Trials at the University of Michigan. "Experiencing fewer short-term side effects potentially allows patients to get back to their normal activities more quickly."