Identification and Management of Head and Neck Cancer Recurrences Detected on Adjuvant Radiation Oncology Simulation Scans.

BACKGROUND/AIM: Computerized tomographic (CT) simulation is used to design precise radiation therapy treatment plans. These scans are not routinely read by radiology and are only used for planning purposes. As radiation oncology departments adopt the addition of intravenous contrast to their CT simulations, there is the potential for identification of post-surgical recurrences.

PATIENTS AND METHODS: We identified all biopsy-proven local recurrences of head and neck cancer detected during CT simulation and followed their outcomes.

RESULTS: A total of 218 patients with head and neck cancer underwent CT simulation with intravenous contrast since our Department adopted the new technique. There were a total of four recurrences detected during simulation: two of the right tongue, one oral cavity and one laryngeal. Intensified salvage chemoradiotherapy was used for these cases. Two out of the four were successfully salvaged and remain disease-free.

CONCLUSION: Recurrences of head and neck cancer following surgical resection can be detected on simulation scans, with the potential for survival after appropriate salvage therapy.