Added value of 3'-deoxy-3'-[18F]fluorothymidine-positron emission tomography for response assessment in patients with head and neck cancer: a systematic review.

BACKGROUND AND PURPOSE: Current tools for evaluating therapy response in head and neck cancer (HNC) have multiple limitations, such as poor representation of heterogeneous tumours, potential complications associated with biopsy collection, and late anti-cancer effects on tumour, leading to delayed evaluation. Therefore, an accurate tool that can assess early therapy response in HNC patients is urgently needed. Positron emission tomography using 3'-deoxy-3'-[18F]fluorothymidine ([18F]FLT-PET) has exhibited preliminary promising roles in measuring therapy response in HNC. This systematic review explores the role of [18F]FLT-PET imaging in assessing treatment response in HNC patients. MATERIALS AND METHODS: Medline and Embase databases via Ovid interface were searched on the basis of the search strategy and selection criteria. Evidence linking the tumour uptake of [18F]FLT-PET with the outcomes of HNC patients was evaluated. RESULTS: Ultimately, eight studies comprising 225 patients showed significant reduction of [18F]FLT uptake early after therapy. Also, two comparative studies that included 58 patients exhibited that post-therapy [18F]FLT-PET uptake was significantly lower than post-therapy [18F]fluorodeoxyglucose ([18F]FDG) uptake in HNC patients. [18F]FLT displayed significant correlation with different clinical endpoints, including local control, disease-free survival and overall survival in four studies, including 123 patients. CONCLUSIONS: [18F]FLT-PET seems to be an accurate and timely tool for assessing therapy response in HNC patients.