Prognostic value of post-induction chemotherapy 18F-FDG PET-CT in stage II/III non-small cell lung cancer before (chemo-) radiation.
Adult
Aged
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung
/ diagnostic imaging
Deoxycytidine
/ analogs & derivatives
Female
Fluorodeoxyglucose F18
/ administration & dosage
Gamma Rays
/ therapeutic use
Humans
Induction Chemotherapy
/ methods
Lung Neoplasms
/ diagnostic imaging
Male
Neoplasm Staging
Pemetrexed
/ therapeutic use
Positron Emission Tomography Computed Tomography
/ methods
Prognosis
Progression-Free Survival
Proportional Hazards Models
Radiopharmaceuticals
/ administration & dosage
Remission Induction
Retrospective Studies
Taxoids
/ therapeutic use
Tumor Burden
/ drug effects
Vinorelbine
/ therapeutic use
Gemcitabine
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2019
2019
Historique:
received:
19
04
2019
accepted:
09
09
2019
entrez:
12
10
2019
pubmed:
12
10
2019
medline:
11
3
2020
Statut:
epublish
Résumé
The purpose of our present study was to assess the prognostic impact of FDG PET-CT after induction chemotherapy for patients with inoperable non-small-cell lung cancer (NSCLC). This retrospective study included 50 patients with inoperable stage II/III NSCLC from January 2012 to July 2015. They were treated for curative intent with induction chemotherapy, followed by concomitant chemoradiation therapy or sequential radiation therapy. FDG PET-CT scans were acquired at initial staging (PET1) and after the last cycle of induction therapy (PET2). Five parameters were evaluated on both scans: SUVmax, SUVpeak, SUVmean, TLG, MTV, and their respective deltas. The prognostic value of each parameter for overall survival (OS) and progression-free survival (PFS) was evaluated with Cox proportional-hazards regression models. Median follow-up was 19 months. PET1 parameters, clinical and histopathological data were not predictive of the outcome. TLG2 and ΔTLG were prognostic factors for OS. TLG2 was the only prognostic factor for PFS. For OS, log-rank test showed that there was a better prognosis for patients with TLG2< 69g (HR = 7.1, 95%CI 2.8-18, p = 0.002) and for patients with ΔTLG< -81% after induction therapy (HR = 3.8, 95%CI 1.5-9.6, p = 0.02). After 2 years, the survival rate was 89% for the patients with low TLG2 vs 52% for the others. We also evaluated a composite parameter considering both MTV2 and ΔSUVmax. Patients with MTV2> 23cc and ΔSUVmax> -55% had significantly shorter OS than the other patients (HR = 5.7, 95%CI 2.1-15.4, p< 0.01). Post-induction FDG PET might be an added value to assess the patients' prognosis in inoperable stage II/III NSCLC. TLG, ΔTLG as well as the association of MTV and ΔSUVmax seemed to be valuable parameters, more accurate than clinical, pathological or pretherapeutic imaging data.
Identifiants
pubmed: 31603916
doi: 10.1371/journal.pone.0222885
pii: PONE-D-19-11190
pmc: PMC6788704
doi:
Substances chimiques
Radiopharmaceuticals
0
Taxoids
0
Pemetrexed
04Q9AIZ7NO
Deoxycytidine
0W860991D6
Fluorodeoxyglucose F18
0Z5B2CJX4D
Vinorelbine
Q6C979R91Y
Gemcitabine
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0222885Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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