Analysis of primary tumor metabolic volume during chemoradiotherapy in locally advanced non-small cell lung cancer

Roengvoraphoj, Olarn; Wijaya, Cherylina; Eze, Chukwuka; Li, Minglun; Dantes, Maurice; Taugner, Julian; Tufman, Amanda; Huber, Rudolf Maria; Belka, Claus and Manapov, Farkhad (2018): Analysis of primary tumor metabolic volume during chemoradiotherapy in locally advanced non-small cell lung cancer. In: Strahlentherapie und Onkologie, Vol. 194, No. 2: pp. 107-115

Abstract

Positron emission tomography with 2aEurodeoxy-2-[fluorine-18] fluoro-d-glucose integrated with computed tomography (18F-FDG-PET/CT) has an established role in the initial diagnosis and staging of lung cancer. However, a prognostic value of PET/CT during multimodality treatment has not yet been fully clarified. This study evaluated the role of primary tumor metabolic volume (PT-MV) changes on PET/CT before, during, and after chemoradiotherapy (CRT). A total of 65 patients with non-small-cell lung cancer (NSCLC) UICC stage IIIA/B (TNM 7th Edition) were treated with definitive chemoradiotherapy ( 6 weeks following CRT. sequential or concurrent setting). PET/CT was acquired before the start, at the end of the third week, and Median overall survival (OS) for the entire cohort was 16 months (95% confidence interval [CI]: 12-20). In all, 60 (92.3%) patients were eligible for pre-treatment (pre-PT-MV), 28 (43%) for mid-treatment (mid-PT-MV), and 53 (81.5%) for post-treatment (post-PT-MV) volume analysis. Patients with pre-PT-MV > 63 cm(3) had worse OS (p < 0.0001). A reduction from mid-PT-MV to post-PT-MV of > 15% improved OS (p = 0.001). In addition, patients with post-PT-MV > 25 cm(3) had significantly worse outcome (p = 0.001). On multivariate analysis, performance status (p = 0.002, hazard ratio [HR] 0.007;95% CI 0.00-0.158), pre-PT-MV1 < 63 cm(3) (p = 0.027, HR 3.98;95% CI 1.17-13.49), post-PT-MV < 25 cm(3) (p = 0.013, HR 11.90;95% CI 1.70-83.27), and a reduction from mid-PT-MV to post-PT-MV > 15% (p = 0.004, HR 0.25;95% CI 0.02-0.31) correlated with improved OS. Our results demonstrated that pre- and post-treatment PT-MV, as well as an at least 15% reduction in mid- to post-PT-MV, significantly correlates with OS in patients with inoperable locally advanced NSCLC.

• Item Type: Journal article
• Faculties: Medicine
• Subjects: 600 Technology > 610 Medicine and health
• ISSN: 0179-7158
• Language: English