Fluorodeoxyglucose positron-emission tomography ratio in non-small cell lung cancer patients treated with definitive radiotherapy.
10.3857/roj.2013.31.3.111
- Author:
Hyun Cheol KANG
1
;
Hong Gyun WU
;
Tosol YU
;
Hak Jae KIM
;
Jin Chul PAENG
Author Information
1. Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea. wuhg@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Non-small-cell lung carcinoma;
Radiotherapy;
Positron-emission tomography;
Prognosis
- MeSH:
Carcinoma, Non-Small-Cell Lung;
Humans;
Lymph Nodes;
Multivariate Analysis;
Positron-Emission Tomography;
Prognosis
- From:Radiation Oncology Journal
2013;31(3):111-117
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To determine whether the maximum standardized uptake value (SUV) of [18F] fluorodeoxyglucose uptake by positron emission tomography (FDG PET) ratio of lymph node to primary tumor (mSUVR) could be a prognostic factor for node positive non-small cell lung cancer (NSCLC) patients treated with definitive radiotherapy (RT). MATERIALS AND METHODS: A total of 68 NSCLC T1-4, N1-3, M0 patients underwent FDG PET before RT. Optimal cutoff values of mSUVR were chosen based on overall survival (OS). Independent prognosticators were identified by Cox regression analysis. RESULTS: The most significant cutoff value for mSUVR was 0.9 with respect to OS. Two-year OS was 17% for patients with mSUVR > 0.9 and 49% for those with mSUVR < or = 0.9 (p = 0.01). In a multivariate analysis, including age, performance status, stage, use of chemotherapy, and mSUVR, only performance status (p = 0.05) and mSUVR > 0.9 (p = 0.05) were significant predictors of OS. Two-year OS for patients with both good performance (Eastern Cooperative Oncology Group [ECOG] < or = 1) and mSUVR < or = 0.9 was significantly better than that for patients with either poor performance (ECOG > 1) or mSUVR > 0.9, 23% (71% vs. 23%, p = 0.04). CONCLUSION: Our results suggested that the mSUVR was a strong prognostic factor among patients with lymph node positive NSCLC following RT. Addition of mSUVR to performance status identifies a subgroup at highest risk for death after RT.
