Routine post-treatment imaging of head and neck cancer patients may not be necessary, UCI-led study finds

Scans linked with false positives instead of improved outcomes

December 07, 2023

Orange, Calif. — A University of California, Irvine-led study has found that routine imaging of patients in remission from head and neck cancers is not as beneficial as previously thought.

UCI Health radiation oncologist Dr. Allen M. Chen and his co-authors reviewed the records of 501 patients who had radiation therapy at UCI Health between 2014 and 2022. Of those, they focused on 340 patients who had a negative scan indicating resolution of disease after completion of initial treatment. The study was published in JAMA Network Open.

The authors found no difference in the survival rate between those who were subsequently imaged regularly and those who were managed expectantly by taking a history and performing physical exams.

Although imaging is valuable when there is suspicion of an issue, the authors recommend discouraging its use in patients who have no symptoms.

Routine imaging may produce a cascade effect, the authors write, “potentially leading to unnecessary procedures (including ironically, in some cases, additional imaging surveillance), increased costs and undue patient anxiety for a finding that is ultimately benign.”

Chen is a board-certified UCI Health radiation oncologist who specializes in the management of head and neck cancers. He serves as chair of the UCI School of Medicine Department of Radiation Oncology. Regarded among the leading international authorities on optimizing cure rates and quality of life for head and neck cancer patients, Chen has published more than 200 papers in peer-reviewed journals.

He also has conducted numerous clinical trials for head and neck cancers including one of the first ever published on the utility of de-escalation for those related to human papillomavirus. He has served on leadership committees for the National Cancer Institute, the Radiological Society of North America, the American Board of Radiology, and is a fellow of the American Society for Radiation Oncology.  

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