Transforming the way that head and neck cancer is monitored

Head and neck cancer can be difficult to monitor using imaging scans. As a result, standard care for patients with some kinds of head and neck cancer is neck surgery after chemoradiotherapy. This can be quite invasive for the patient, is technically difficult for surgeons, and carries risks of complications. However, other techniques to monitor the cancer in these patients are limited, and so surgery is necessary.

To remedy this situation and develop a less invasive way to monitor people with head and neck cancer, the PET-NECK study set out to investigate if PET-CT scans could be used to monitor disease in patients after chemoradiotherapy, with neck surgery only used on those that still had unclear results, rather than surgery as routine treatment.

The NCRI Head and Neck Cancer Clinical Studies Group (CSG) was at the centre of the development and support for the study.

Professor Hisham Mehanna, lead researcher on the study, explained how the CSG supported the study: “The CSG was essential in developing the idea, applying for funding, running the study and ensuring and encouraging recruitment.”

Prof Mehanna continued: “The study would have … probably not happened if there had not been the input and coordination of the CSG.”

The value of the NCRI CSGs to studies like this is far-reaching; as explained by Professor Mehanna, the CSG “originates new ideas, develops them, helps others to develop their ideas, has significant expertise in obtaining grants, is able to access the wider head and neck community and encourage recruitment and participation.”

The study successfully showed that PET-CT could be used as a monitoring technique, and safely avoid the need for neck dissection surgery in 80% of patients*. Not only does this have great cost-saving potentials, the avoidance of invasive surgery and its potential complications is a huge improvement in the care of patients.

Because of this study, PET-CT guided surveillance has now become standard care in the NHS. This research will benefit around 2,500 patients every year, estimates Professor Mehanna.

 

*The results of this study can be found in the publication: Mehanna, H et al. (2016). PET-CT surveillance vs neck dissection in advanced head and neck cancer. New England Journal of Medicine, 374;15 1444-1454.