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01-02-2018 | Original Article

Analysis of primary tumor metabolic volume during chemoradiotherapy in locally advanced non-small cell lung cancer

Authors: Olarn Roengvoraphoj, MD, Cherylina Wijaya, MD, Chukwuka Eze, MD, Minglun Li, Maurice Dantes, MD, Julian Taugner, Amanda Tufman, MD, Rudolf Maria Huber, MD PhD, Claus Belka, MD PhD, Farkhad Manapov, MD

Published in: Strahlentherapie und Onkologie | Issue 2/2018

Abstract

Purpose

Positron emission tomography with 2‑deoxy-2-[fluorine-18] fluoro-d-glucose integrated with computed tomography (18F-FDG-PET/CT) has an established role in the initial diagnosis and staging of lung cancer. However, a prognostic value of PET/CT during multimodality treatment has not yet been fully clarified. This study evaluated the role of primary tumor metabolic volume (PT-MV) changes on PET/CT before, during, and after chemoradiotherapy (CRT).

Methods

A total of 65 patients with non-small-cell lung cancer (NSCLC) UICC stage IIIA/B (TNM 7th Edition) were treated with definitive chemoradiotherapy (sequential or concurrent setting). PET/CT was acquired before the start, at the end of the third week, and 6 weeks following CRT.

Results

Median overall survival (OS) for the entire cohort was 16 months (95% confidence interval [CI]: 12–20). In all, 60 (92.3%) patients were eligible for pre-treatment (pre-PT-MV), 28 (43%) for mid-treatment (mid-PT-MV), and 53 (81.5%) for post-treatment (post-PT-MV) volume analysis. Patients with pre-PT-MV >63 cm³ had worse OS (p < 0.0001). A reduction from mid-PT-MV to post-PT-MV of >15% improved OS (p = 0.001). In addition, patients with post-PT-MV > 25 cm³ had significantly worse outcome (p = 0.001). On multivariate analysis, performance status (p = 0.002, hazard ratio [HR] 0.007; 95% CI 0.00–0.158), pre-PT-MV1 < 63 cm³ (p = 0.027, HR 3.98; 95% CI 1.17–13.49), post-PT-MV < 25 cm³ (p = 0.013, HR 11.90; 95% CI 1.70–83.27), and a reduction from mid-PT-MV to post-PT-MV > 15% (p = 0.004, HR 0.25; 95% CI 0.02–0.31) correlated with improved OS.

Conclusions

Our results demonstrated that pre- and post-treatment PT-MV, as well as an at least 15% reduction in mid- to post-PT-MV, significantly correlates with OS in patients with inoperable locally advanced NSCLC.

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Title: Analysis of primary tumor metabolic volume during chemoradiotherapy in locally advanced non-small cell lung cancer
Authors: Olarn Roengvoraphoj, MD
Cherylina Wijaya, MD
Chukwuka Eze, MD
Minglun Li
Maurice Dantes, MD
Julian Taugner
Amanda Tufman, MD
Rudolf Maria Huber, MD PhD
Claus Belka, MD PhD
Farkhad Manapov, MD
Publication date: 01-02-2018
Publisher: Springer Berlin Heidelberg
Published in: Strahlentherapie und Onkologie / Issue 2/2018
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-017-1229-3

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Analysis of primary tumor metabolic volume during chemoradiotherapy in locally advanced non-small cell lung cancer

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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