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Article: Greater reduction in mid-treatment FDG-PET volume may be associated with worse survival in non-small cell lung cancer

TitleGreater reduction in mid-treatment FDG-PET volume may be associated with worse survival in non-small cell lung cancer
Authors
KeywordsNon-small cell lung cancer
FDG-PET
Mid-treatment
Metabolic tumor volume
Issue Date2018
Citation
Radiotherapy and Oncology, 2018 How to Cite?
Abstract© 2018 Elsevier B.V. Background and purpose: This study tested the hypotheses that 1) changes in mid-treatment fluorodeoxyglucose (FDG)-positron emission tomography (PET) parameters are predictive of overall survival (OS) and 2) mid-treatment FDG-PET–adapted treatment has the potential to improve survival in patients with non-small cell lung cancer (NSCLC). Material and methods: Patients with stage I-III NSCLC requiring daily fractionated radiation were eligible. FDG-PET-CT scans were obtained prior to and mid-treatment with radiotherapy at 40–50 Gy. The normalized maximum standardized uptake value (NSUVmax), normalized mean SUV (NSUVmean), PET-metabolic tumor volume (MTV), total lesion glycolysis (TLG), and computed tomography-based gross tumor volume (CT-GTV) were consistently measured for all patients. The primary study endpoint was OS. Results: The study is comprised of 102 patients who received 3-dimensional conformal radiotherapy, among whom 30 patients who received mid-treatment PET-adapted dose escalation radiotherapy. All PET-CT parameters decreased significantly (P < 0.001) mid-treatment, with greater reductions in FDG-volumetric parameters compared to FDG-activity factors. Mid-treatment changes in MTV (P = 0.053) and TLG (P = 0.021) were associated with OS, while changes in NSUVmax, NSUVmean, and CT-GTV were not (all Ps>0.1). Patients receiving conventional radiation (60-70 Gy) with MTV reductions greater than the mean had a median survival of 14 months, compared to those with MTV reductions less than the mean who had a median survival of 22 months. By contrast, patients receiving mid-treatment PET-adapted radiation with MTV reductions greater than the mean had a median survival of 33 months, compared to those with MTV reductions less than the mean who had a median survival of 19 months. Overall, PET-adapted treatment resulted in a 19% better 5-year survival than conventional radiation. Conclusion: Changes in mid-treatment PET-volumetric parameters were significantly associated with survival in NSCLC. A greater reduction in the mid-treatment MTV was associated with worse survival in patients treated with standard radiation, but with better survival in patients who received mid-treatment PET-adapted treatment.
Persistent Identifierhttp://hdl.handle.net/10722/266852
ISSN
2017 Impact Factor: 4.942
2015 SCImago Journal Rankings: 2.654

 

DC FieldValueLanguage
dc.contributor.authorKong, Feng Ming (Spring)-
dc.contributor.authorLi, Ling-
dc.contributor.authorWang, Weili-
dc.contributor.authorCampbell, Jeff-
dc.contributor.authorWaller, Jennifer L.-
dc.contributor.authorPiert, Morand-
dc.contributor.authorGross, Milton-
dc.contributor.authorCheng, Monica-
dc.contributor.authorOwen, Dawn-
dc.contributor.authorStenmark, Matthew-
dc.contributor.authorHuang, Ke Colin-
dc.contributor.authorFrey, Kirk A.-
dc.contributor.authorTen Haken, Randall K.-
dc.contributor.authorLawrence, Theodore S.-
dc.date.accessioned2019-01-31T07:19:48Z-
dc.date.available2019-01-31T07:19:48Z-
dc.date.issued2018-
dc.identifier.citationRadiotherapy and Oncology, 2018-
dc.identifier.issn0167-8140-
dc.identifier.urihttp://hdl.handle.net/10722/266852-
dc.description.abstract© 2018 Elsevier B.V. Background and purpose: This study tested the hypotheses that 1) changes in mid-treatment fluorodeoxyglucose (FDG)-positron emission tomography (PET) parameters are predictive of overall survival (OS) and 2) mid-treatment FDG-PET–adapted treatment has the potential to improve survival in patients with non-small cell lung cancer (NSCLC). Material and methods: Patients with stage I-III NSCLC requiring daily fractionated radiation were eligible. FDG-PET-CT scans were obtained prior to and mid-treatment with radiotherapy at 40–50 Gy. The normalized maximum standardized uptake value (NSUVmax), normalized mean SUV (NSUVmean), PET-metabolic tumor volume (MTV), total lesion glycolysis (TLG), and computed tomography-based gross tumor volume (CT-GTV) were consistently measured for all patients. The primary study endpoint was OS. Results: The study is comprised of 102 patients who received 3-dimensional conformal radiotherapy, among whom 30 patients who received mid-treatment PET-adapted dose escalation radiotherapy. All PET-CT parameters decreased significantly (P < 0.001) mid-treatment, with greater reductions in FDG-volumetric parameters compared to FDG-activity factors. Mid-treatment changes in MTV (P = 0.053) and TLG (P = 0.021) were associated with OS, while changes in NSUVmax, NSUVmean, and CT-GTV were not (all Ps>0.1). Patients receiving conventional radiation (60-70 Gy) with MTV reductions greater than the mean had a median survival of 14 months, compared to those with MTV reductions less than the mean who had a median survival of 22 months. By contrast, patients receiving mid-treatment PET-adapted radiation with MTV reductions greater than the mean had a median survival of 33 months, compared to those with MTV reductions less than the mean who had a median survival of 19 months. Overall, PET-adapted treatment resulted in a 19% better 5-year survival than conventional radiation. Conclusion: Changes in mid-treatment PET-volumetric parameters were significantly associated with survival in NSCLC. A greater reduction in the mid-treatment MTV was associated with worse survival in patients treated with standard radiation, but with better survival in patients who received mid-treatment PET-adapted treatment.-
dc.languageeng-
dc.relation.ispartofRadiotherapy and Oncology-
dc.subjectNon-small cell lung cancer-
dc.subjectFDG-PET-
dc.subjectMid-treatment-
dc.subjectMetabolic tumor volume-
dc.titleGreater reduction in mid-treatment FDG-PET volume may be associated with worse survival in non-small cell lung cancer-
dc.typeArticle-
dc.description.natureLink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.radonc.2018.10.006-
dc.identifier.scopuseid_2-s2.0-85055680658-
dc.identifier.spagenull-
dc.identifier.epagenull-
dc.identifier.eissn1879-0887-

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