Large Decreases in Standardized Uptake Values After Definitive Radiation Are Associated with Better Survival of Patients with Locally Advanced Non–Small Cell Lung Cancer

Journal of Nuclear Medicine

Ritsuko Komaki¹  Zhongxing Liao¹  Jose L. Lopez Guerra¹  Daniel Gomez¹  Gregory Gladish¹  Yan Zhuang¹ 

关键词: non–small cell lung cancer;    radiation therapy;    standardized uptake value;    chemoradiation therapy;    positron emission tomography;   

DOI  :  10.2967/jnumed.111.096305

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

We evaluated potential associations between maximum standardized uptake value (SUVmax) on 18F-FDG PET before and after radiation therapy (RT) and survival outcomes for patients with locally advanced non–small cell lung cancer. Methods: Patients with stage III non–small cell lung cancer (n = 49) who had undergone 18F-FDG PET at the M.D. Anderson Cancer Center both before and up to 3.5 mo after undergoing radiochemotherapy were studied; exclusion criteria were patients with a history of thoracic surgery, RT, or other cancer or those who had received a total radiation dose less than 60 Gy. We assessed associations between overall survival (OS) or disease-free survival (DFS) and post-RT SUVmax and the extent of decrease in SUVmax in the primary tumor (PT) and regional lymph nodes (LNs). SUVmax was assessed as a continuous variable by Cox proportional hazards regression analysis. Results: Univariate and multivariate analyses showed that having a high post-RT SUVmax (either PT or LNs) was associated with a higher risk of death (univariate analyses: hazard ratio [HR] for PT SUVmax, 1.27, P < 0.0001; HR for LN SUVmax, 1.32, P = 0.004) and disease recurrence (univariate analyses: HR for PT SUVmax, 1.16, P = 0.004; HR for LN SUVmax, 1.32, P = 0.001). Moreover, after definitive RT, the greater the decrease in SUVmax in the lesion that had the highest SUVmax at diagnosis, the longer the OS (HR, 0.06; P = 0.002), DFS (HR, 0.03; P = 0.001), local–regional control (HR, 0.04; P = 0.002), and distant metastasis-free survival (HR, 0.07; P = 0.028). Conclusion: The post-RT SUVmax in both the PT and the LNs was a predictor of survivalspecifically, the higher the residual SUVmax after RT, the poorer the OS and DFS; and the greater the decrease in SUVmax in the lesion with the highest SUVmax at diagnosis, the longer the OS and DFS. This information should help to identify patients who are at high risk of recurrence and for whom additional treatments can be designed accordingly.

【 授权许可】

Unknown