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Predictive value of interim 18F-FDG-PET in patients with non-small cell lung cancer treated with definitive radiation therapy.
- Source :
-
PloS one [PLoS One] 2020 Jul 20; Vol. 15 (7), pp. e0236350. Date of Electronic Publication: 2020 Jul 20 (Print Publication: 2020). - Publication Year :
- 2020
-
Abstract
- Purpose: We evaluated that early metabolic response determined by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) during radiotherapy (RT), predicts outcomes in non-small cell lung cancer.<br />Material and Methods: Twenty-eight patients evaluated using pretreatment 18F-FDG-PET/CT (PETpre) and interim 18F-FDG-PET/CT (PETinterim) after 11 fractions of RT were retrospectively reviewed. Maximum standardized uptake value (SUVmax) was calculated for primary lesion. Predictive value of gross tumor volume (ΔGTV) and SUVmax (ΔSUVmax) changes was evaluated for locoregional control (LRC), distant failure (DF), and overall survival (OS). Metabolic responders were patients with ΔSUVmax >40%.<br />Results: Metabolic responders showed better trends in 1-year LRC (90.9%) than non-responders (47.1%) (p = 0.086). Patients with large GTVpre (≥120 cc) demonstrated poor LRC (hazard ratio 4.14, p = 0.022), while metabolic non-responders with small GTVpre (<120 cc) and metabolic responders with large GTVpre both had 1-year LRC rates of 75.0%. Reduction of 25% in GTV was not associated with LRC; however, metabolic responders without a GTV response showed better 1-year LRC (83.3%) than metabolic non-responders with a reduction in GTV (42.9%). Metabolic responders showed lower 1-year DF (16.7%) than non-responders (50.0%) (p = 0.025). An ΔSUVmax threshold of 40% yielded accuracy of 64% for predicting LRC, 75% for DF, and 54% for OS. However, ΔGTV > 25% demonstrated inferior diagnostic values than metabolic response.<br />Conclusions: Changes in tumor metabolism diagnosed using PETinterim during RT better predicted treatment responses, recurrences, and prognosis than other factors historically used.<br />Competing Interests: The authors have declared that no competing interests exist.
- Subjects :
- Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Carcinoma, Non-Small-Cell Lung diagnosis
Carcinoma, Non-Small-Cell Lung mortality
Carcinoma, Non-Small-Cell Lung pathology
Female
Fluorodeoxyglucose F18 administration & dosage
Follow-Up Studies
Humans
Lung pathology
Lung radiation effects
Lung Neoplasms diagnosis
Lung Neoplasms mortality
Lung Neoplasms pathology
Male
Neoplasm Recurrence, Local epidemiology
Neoplasm Recurrence, Local prevention & control
Predictive Value of Tests
Prognosis
Progression-Free Survival
Radiopharmaceuticals administration & dosage
Retrospective Studies
Survival Rate
Tumor Burden drug effects
Tumor Burden radiation effects
Carcinoma, Non-Small-Cell Lung therapy
Chemoradiotherapy
Lung diagnostic imaging
Lung Neoplasms therapy
Neoplasm Recurrence, Local diagnosis
Positron Emission Tomography Computed Tomography methods
Subjects
Details
- Language :
- English
- ISSN :
- 1932-6203
- Volume :
- 15
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- PloS one
- Publication Type :
- Academic Journal
- Accession number :
- 32687531
- Full Text :
- https://doi.org/10.1371/journal.pone.0236350