1. Chemotherapy response evaluation with 18F-FDG PET in patients with non-small cell lung cancer
- Author
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Antoon T. M. Willemsen, Lioe-Fee de Geus-Oei, Paul F M Krabbe, Eric P. Visser, Frans H.M. Corstens, Johanna N. H. Timmer-Bonte, Wim J.G. Oyen, Rick Hermsen, Henricus F. M. van der Heijden, Bas A. van Hoorn, Jan Pruim, Methods in Medicines evaluation & Outcomes research (M2O), and Guided Treatment in Optimal Selected Cancer Patients (GUTS)
- Subjects
Male ,Oncology ,Lung Neoplasms ,PREDICTION ,Aetiology, screening and detection [ONCOL 5] ,GUIDELINES ,THERAPY ,Carcinoma, Non-Small-Cell Lung ,Antineoplastic Combined Chemotherapy Protocols ,F-18-FDG PET ,FDG-PET ,Heart, lung and circulation [UMCN 2.1] ,Prospective cohort study ,Netherlands ,chemotherapy response monitoring ,Middle Aged ,Prognosis ,Survival Rate ,Pathogenesis and modulation of inflammation [N4i 1] ,TRIALS ,Treatment Outcome ,Patlak analysis ,Response Evaluation Criteria in Solid Tumors ,Female ,Adult ,medicine.medical_specialty ,Age-related aspects of cancer [ONCOL 2] ,Antineoplastic Agents ,Standardized uptake value ,END-POINT ,Sensitivity and Specificity ,Patlak plot ,CHEMORADIOTHERAPY ,Quality of Care [ONCOL 4] ,POSITRON-EMISSION-TOMOGRAPHY ,Fluorodeoxyglucose F18 ,Translational research [ONCOL 3] ,Interventional oncology [UMCN 1.5] ,Internal medicine ,Image Interpretation, Computer-Assisted ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Lung cancer ,Survival rate ,non-small cell lung cancer ,Survival analysis ,Aged ,business.industry ,Reproducibility of Results ,Cancer ,PATHOLOGICAL RESPONSE ,medicine.disease ,Survival Analysis ,DEFINITION ,Evaluation of complex medical interventions [NCEBP 2] ,Positron-Emission Tomography ,standardized uptake value ,Functional Imaging [UMCN 1.1] ,business ,Nuclear medicine - Abstract
Contains fulltext : 53274.pdf (Publisher’s version ) (Closed access) The aim of this prospective study was to evaluate the value of (18)F-FDG PET for the assessment of chemotherapy response in patients with non-small cell lung cancer. Furthermore, part of the objective of this study was to compare 2 methods to quantify changes in glucose metabolism. METHODS: In 51 patients, dynamic (18)F-FDG PET was performed before and at 5-8 wk into treatment. Simplified methods to measure glucose metabolism (standardized uptake value [SUV]) and quantitative measures (metabolic rate of glucose [MR(Glu)]), derived from Patlak analysis, were evaluated. The overall survival and progression-free survival with respect to MR(Glu) and SUV were calculated using Kaplan-Meier estimates. Fractional changes in tumor glucose use were stratified by the median value and also the predefined EORTC (European Organization for Research and Treatment of Cancer) metabolic response criteria, and criteria applying cutoff levels similar to those of RECIST (Response Evaluation Criteria in Solid Tumors) were evaluated. RESULTS: When stratifying at the median value of DeltaMR(Glu) and DeltaSUV, the difference in overall survival (P = 0.017 for DeltaMR(Glu), P = 0.018 for DeltaSUV) and progression-free survival (P = 0.002 for DeltaMR(Glu), P = 0.0009 for DeltaSUV) was highly significant. When applying the predefined criteria for metabolic response, the cutoff levels as also used for size measurement (RECIST) showed significant differences for DeltaSUV between response categories in progression-free survival (P = 0.0003) as well as overall survival (P = 0.027). CONCLUSION: The degree of chemotherapy-induced changes in tumor glucose metabolism as determined by (18)F-FDG PET is highly predictive for patient outcome, stratifying patients into groups with widely differing overall survival and progression-free survival probabilities. The use of (18)F-FDG PET for therapy monitoring seems clinically feasible, because simplified methods to measure tumor glucose use (SUV) are sufficiently reliable and can replace more complex, quantitative measures (MR(Glu)) in this patient population.
- Published
- 2007