How much primary tumor metabolic volume reduction is required to improve outcome in stage III NSCLC after chemoradiotherapy? A single-centre experience

Roengvoraphoj, Olarn; Eze, Chukwuka; Wijaya, Cherylina; Dantes, Maurice; Taugner, Julian; Tufman, Amanda; Huber, Rudolf Maria; Bartenstein, Peter; Belka, Claus und Manapov, Farkhad (2018): How much primary tumor metabolic volume reduction is required to improve outcome in stage III NSCLC after chemoradiotherapy? A single-centre experience. In: European Journal of Nuclear Medicine and Molecular Imaging, Bd. 45, Nr. 12: S. 2103-2109

Abstract

PurposeWe analysed a correlation between pre- to post-treatment primary tumour metabolic volume (PT-MV) reduction on 18F-FDG-PET/CT and survival in non-small cell lung cancer (NSCLC) patients treated with chemoradiotherapy (CRT).Methods: Sixty consecutive patients with NSCLC stage IIIA-B (UICC 7th edition), treated with chemoradiotherapy, who underwent 18F-FDG-PET/CT at the same institution before and 6weeks after treatment, were analysed. Different metabolic response values were investigated on their correlation with survival parameters: complete response (100% PT-MV reduction);major response (80-99% PT-MV reduction);moderate response (50-79% PT-MV reduction);minor response (1-49% PT-MV reduction) and non-response (no change or increase in uptake).Results: From 60 patients, 52 (87%) had repeat PET/CT scans 6weeks after completion of CRT. Complete metabolic response (CR) was reached in ten (17%), whereas major and moderate metabolic responses occurred in 16 (27%) and 15 (25%) patients, respectively. Four patients (7%) had minor metabolic response. Non-response was documented in seven patients (12%). Median overall survival (MS) for the entire cohort was 17months (95% CI: 11.9-22.1months). MS according to the different metabolic response values was as follows: 34months (95% CI: 0-84.1);22months (95% CI: 14.2-29.8);12months (95% CI: 0.4-23.6);11months (95% CI: 0.2-21.8) and 17months in patients with complete, major, moderate, minor and non-response (95% CI: 6.7-27.3), respectively (p=0.008).On multivariate analysis, significant predictors of survival included ECOG performance status (p=0.035, HR 0.49, 95% CI: 0.25-0.95) as well as complete and major metabolic response as a continuous variable with PT-MV reduction of at least 80% (p=0.021, HR 0.36, 95% CI: 0.15-0.86). Moderate metabolic response did not correlate with improved outcome (p=0.522).Conclusion: sIn this homogeneous locally-advanced NSCLC single-centre patient cohort, a PT-MV reduction of at least 80% (complete and major metabolic response) following CRT was necessary to significantly improve patient outcome.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1619-7070
• Sprache: Englisch