简介：Headandneckcancers(HNCs)areaggressivetumorsthattypicallydemonstrateahighglycolyticrate,whichresultsinresistancetocytotoxictherapyandpoorprognosis.Duetotheirlocationthesetumorsspecificallyimpairfoodintakeandqualityoflife,sothatpreventionofweightlossthroughnutritionsupportbecomesanimportanttreatmentgoal.Dietaryrestrictionofcarbohydrates(CHOs)andtheirreplacementwithfat,mostlyinformofaketogenicdiet(KD),havebeensuggestedtoaccommodateforboththealteredtumorcellmetabolismandcancer-associatedweightloss.Inthisreview,IpresentthreespecificrationalesforCHOrestrictionandnutritionalketosisassupportivetreatmentoptionsfortheHNCpatient.Theseare(1)targetingtheoriginandspecificaspectsoftumorglycolysis;(2)protectingnormaltissuefrombutsensitizingtumortissuetoradiation-andchemotherapyinducedcellkill;(3)supportingbodyandmusclemassmaintenance.WhilemostofthesebenefitsofCHOrestrictionapplytocanceringeneral,specificaspectsofimplementationarediscussedinrelationtoHNCpatients.WhileCHOrestrictionseemsfeasibleinHNCpatientstheavailableevidenceindicatesthatitsrolemayextendbeyondfightingmalnutritiontofightingHNCitself.

简介：Objective:Toclarifytheprognosticvalueofpost-treatment18F-fluorodeoxyglucose(FDG)positronemissiontomography(PET)/computedtomography(CT)inpatientswithadvancedheadandnecksquamouscellcarcinoma(HNSCC)aftercombinedintra-arterialchemotherapyandradiotherapy(IACR).Methods:Thirty-sixpatientswithHNSCCwhounderwentIACRwererecruited.TheperiodfromtheendofIACRtothelastpost-treatment18F-FDGPET/CTexaminationwas8-12weeks.Bothpatient-basedandlesion-basedanalyseswereusedtoevaluatethePET/CTimages.Forlesion-basedanalysis,36regions(12lesionsofrecurrencesand24scarsatprimarysites)wereselected.TheKaplan-Meiermethodwasusedtoassesstheoverallsurvival(OS)stratifiedby18F-FDGuptakeorvisualinterpretationresults.Results:TwelvepatientswithrecurrencewereidentifiedbysixmonthsafterIACR.Thesensitivityandspecificityinthepatient-basedanalysiswere67%(8/12)and88%(21/24),respectively.ThemeanOSwasestimatedtobe12.1months(95%CI,6.3-18.0months)forthehighermaximumstandardizeduptakevalue(SUVmax)group(n=7)and44.6months(95%CI,39.9-49.3months)forthelowerSUVmaxgroup(n=29).OSinthehigherSUVmaxgroup(cut-offpoint,6.1)orpositivevisualinterpretationgroupwassignificantlyshorterthanthatinthelowerSUVmaxornegativevisualinterpretationgroup(P<0.001andP<0.05,respectively).Conclusions:TheSUVmaxandvisualinterpretationofHNSCConpost-IACR18F-FDGPET/CTcanprovideprognosticsurvivalestimates.