Visualization of Scattered Tumor Regression Following Neoadjuvant Chemoimmunotherapy With a Novel Intraoperative PET/CT Scanner.

IF 2.2 3区医学 Q1 OTORHINOLARYNGOLOGY

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2026-11-01 Epub Date: 2026-05-25 DOI:10.1002/hed.70333

Andreja Radevic, Joaquin Austerlitz, Ashtyn McAdoo, Kyrionna Golliday, Takeshi Takahashi, Mitra Mehrad, Adam J Rosenberg, Barbara A Murphy, Eben Rosenthal, Michael C Topf

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引用次数: 0

Abstract

Background: Neoadjuvant chemoimmunotherapy is being explored in locally advanced head and neck squamous cell carcinoma (HNSCC), yet the spatial patterns of pathologic response and clinical implications remain poorly characterized.

Methods: A 79-year-old female with recurrent left oral tongue SCC (PD-L122C3 Combined Positive Score 90) who underwent prior resection and free flap reconstruction received neoadjuvant pembrolizumab, paclitaxel, and carboplatin followed by definitive surgical resection with intraoperative positron emission tomography/computed tomography (PET/CT) imaging.

Results: Final histopathology revealed two discrete foci of residual poorly differentiated SCC, measuring 1.8 and 0.5 cm, separated by an 8 mm intervening bridge of inflammation without viable tumor. Intraoperative PET/CT with 3D specimen mapping confirmed the spatial relationship between residual foci and intervening treatment effect.

Conclusions: Pathologic response to neoadjuvant chemoimmunotherapy in HNSCC can manifest as a multifocal regression pattern. Intraoperative real-time approaches to assessing treatment response warrant further investigation.

Trial registration: ClinicalTrials.gov identifier: NCT06915454.

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新型术中PET/CT扫描显示新辅助化疗免疫治疗后散在性肿瘤消退。

背景：新辅助化学免疫治疗正在探索局部晚期头颈部鳞状细胞癌（HNSCC），但病理反应的空间模式和临床意义仍然缺乏特征。方法：一名79岁女性复发性左舌SCC （PD-L122C3联合阳性评分90）患者，术前行切除和游离瓣重建，接受新辅助派姆单抗、紫杉醇和卡铂治疗，术后行手术切除并术中正电子发射断层扫描/计算机断层扫描（PET/CT）成像。结果：最终的组织病理学显示两个离散的残余低分化SCC灶，分别为1.8和0.5 cm，由8 mm的炎症桥隔开，没有存活的肿瘤。术中PET/CT三维标本作图证实了残留病灶与介入治疗效果的空间关系。结论：HNSCC新辅助化疗免疫治疗的病理反应可表现为多灶性消退模式。术中实时评估治疗反应的方法值得进一步研究。试验注册：ClinicalTrials.gov标识符：NCT06915454。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.