Evaluation of 201T1 SPECT for predicting early treatment response in patients with squamous cell carcinoma of the extracranial head and neck treated with nonsurgical organ preservation therapy: initial results.

Purpose: The purpose of this work was to prospectively determine the ability of 210TI single photon emission CT (SPECT) to monitor treatment response in patients with head and neck squamous cell carcinoma (HNSCCA) treated with nonsurgical organ preservation.

Method: Nine patients with HNSCCA underwent 201T1 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 tumors had abnormal radiotracer uptake on the pretreatment study. The posttreatment thallium studies were evaluated for uptake and correlated with local control at the primary site in all cases.

Results: All patients had abnormal thallium uptake on pretreatment studies. Of the nine patients, four cases were locally controlled by nonsurgical organ preservation therapy. All of these patients had no evidence of thallium uptake on posttreatment studies. Five cases failed treatment at the primary site. All five patients demonstrated abnormal radiotracer uptake at the primary site.

Conclusion: Our initial results suggest that 201T1 SPECT may be an accurate technique for monitoring HNSCCA treated with nonsurgical organ preservation therapy.