Evaluation of Tl-201 SPECT for predicting early treatment response in patients with squamous cell carcinoma of the extracranial head and neck treatedwith nonsurgical organ preservation therapy: Initial results

Purpose: The purpose of this work was to prospectively determine the abilit y of Tl-210 single photon emission CT (SPECT) to monitor treatment response in patients with head and neck squamous cell carcinoma (HNSCCA) treated wi th nonsurgical organ preservation. Method: Nine patients with HNSCCA underwent Tl-201 SPECT before and 6 weeks after completion of nonsurgical organ preservation therapy. All cases were evaluated for uptake at the primary site before and after treatment. All t umors had abnormal radiotracer uptake on the pretreatment study. The posttr eatment thallium studies were evaluated for uptake and correlated with loca l control at the primary site in all cases. Results: All patients had abnormal thallium uptake on pretreatment studies, bf the nine patients, four cases were locally controlled by nonsurgical or gan preservation therapy. All of these patients had net evidence of thalliu m uptake on posttreatment studies. Five cases failed treatment at the prima ry site. All five patients demonstrated abnormal radiotracer uptake at the primary site. Conclusion: Our initial results suggest that Tl-201 SPECT may be an accurat e technique for monitoring HNSCCA treated with nonsurgical organ preservati on therapy.