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Effect of PET/CT on management of patients with non-small cell lung cancer: results of a prospective study with 5-year survival data.
- Source :
-
Journal of nuclear medicine : official publication, Society of Nuclear Medicine [J Nucl Med] 2012 Jul; Vol. 53 (7), pp. 1007-15. Date of Electronic Publication: 2012 Jun 07. - Publication Year :
- 2012
-
Abstract
- Unlabelled: We investigated the incremental management impact and prognostic value of staging with (18)F-FDG PET/CT in patients with non-small cell lung cancer (NSCLC) being considered for potentially curative therapies.<br />Methods: Information on 168 consecutive patients with NSCLC being considered for surgery or definitive radiotherapy with curative intent before PET/CT was entered into a prospective database. The pre-PET/CT management plan, based on conventional imaging (conventional CT, appropriately supplemented by bone scintigraphy or other modalities), was defined prospectively by referring clinicians before PET/CT results became available. After PET/CT, actual clinical management was recorded, and patients were followed up until 5 y or death. The appropriateness of PET/CT management plans was assessed by biopsy when available, clinical follow-up, and survival analysis.<br />Results: Stage was discordant on PET/CT and conventional imaging in 50.6% of patients (41.1% upstaged, 9.5% downstaged), with high management impact (change in treatment modality or curative intent) in 42.3% of patients. Both conventional imaging stage and PET/CT stage were strongly predictive of overall survival (OS) but there were greater differences between hazard rates and separations in the OS curves for stage groupings determined using PET/CT. OS was also strongly predicted by PET/CT-directed choice of therapy (P < 0.0001).<br />Conclusion: PET/CT frequently affects patient management and strongly predicts OS in NSCLC, supporting the appropriateness of such changes.
- Subjects :
- Aged
Aged, 80 and over
Bone and Bones diagnostic imaging
Case Management
Combined Modality Therapy
Female
Fluorodeoxyglucose F18
Humans
Image Processing, Computer-Assisted
Kaplan-Meier Estimate
Male
Middle Aged
Neoplasm Staging
Palliative Care
Patient Care Team
Predictive Value of Tests
Proportional Hazards Models
Prospective Studies
Radiopharmaceuticals
Reproducibility of Results
Survival Analysis
Carcinoma, Non-Small-Cell Lung diagnostic imaging
Carcinoma, Non-Small-Cell Lung therapy
Lung Neoplasms diagnostic imaging
Lung Neoplasms therapy
Positron-Emission Tomography methods
Subjects
Details
- Language :
- English
- ISSN :
- 1535-5667
- Volume :
- 53
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Journal of nuclear medicine : official publication, Society of Nuclear Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 22677701
- Full Text :
- https://doi.org/10.2967/jnumed.111.099713