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Radiation Oncology
Published in: Radiation Oncology 1/2014

Open Access 01-12-2014 | Research

Pretreatment SUVmax predicts progression-free survival in early-stage non-small cell lung cancer treated with stereotactic body radiation therapy

Authors: Zachary D Horne, David A Clump, John A Vargo, Samir Shah, Sushil Beriwal, Steven A Burton, Annette E Quinn, Matthew J Schuchert, Rodney J Landreneau, Neil A Christie, James D Luketich, Dwight E Heron

Published in: Radiation Oncology | Issue 1/2014

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Abstract

Background

This retrospective study aims to assess the usefulness of SUVmax from FDG-PET imaging as a prognosticator for primary biopsy-proven stage I NSCLC treated with SBRT.

Methods

This study includes 95 patients of median age 77 years, with primary, biopsy-confirmed peripheral stage IA/IB NSCLC. All patients were treated with 60Gy in 3 fractions with a median treatment time of six days. Local, regional, and distant failures were evaluated independently according to the terms of RTOG1021. Local, regional, and distant control, overall- and progression-free survival were estimated by the Kaplan-Meier method. Cox proportional hazards regression was performed to determine whether SUVmax, age, KPS, gender, tumor size/T stage, or smoking history influenced outcomes. SUVmax was evaluated as both a continuous and as a dichotomous variable using a cutoff of <5 and ≥5.

Results

Median follow-up for the cohort was 16 months. Median OS and PFS were 25.3 and 40.3 months, respectively. SUV with a cutoff value of 5 predicted for OS and PFS (p = .024 for each) but did not achieve significance for LC (p = .256). On Cox univariate regression analysis, SUV as a dichotomous variable predicted for both OS and PFS (p = .027 and p = .030, respectively). Defined as a continuous variable, SUVmax continued to predict for OS and PFS (p = .032 and p = .003), but also predicted LC (p = .045) and trended toward significance for DC (p = .059).
SUVmax did not predict for OS as a dichotomous or continuous variable. It did, however, predict for PFS as a continuous variable (p = .008), neared significance for local control (p = .057) and trended towards, significance for distant control (p = .092).

Conclusions

SUVmax appears to be a statistically and clinically significant independent prognostic marker for progression-free survival in patients with stage I NSCLC treated with SBRT. Prospective studies to more accurately define the role of tumor FDG uptake in the prognosis of NSCLC are warranted.
Appendix
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Literature
1.
Kligerman S, Digumarthy S: Staging of non-small cell lung cancer using integrated PET/CT. AJR Am J Roentgenol 2009,193(5):1203-1211. 10.2214/AJR.09.3193CrossRefPubMed
2.
Mac Manus MP, Hicks RJ: The role of positron emission tomography/computed tomography in radiation therapy planning for patients with lung cancer. Semin Nucl Med 2012,42(5):308-319. 10.1053/j.semnuclmed.2012.04.003CrossRefPubMed
3.
Paesmans M, Berghmans T, Dusart M, et al.: Primary tumor standardized uptake value measured on fluorodeoxyglucose positron emission tomography is of prognostic value for survival in non-small cell lung cancer: update of a systematic review and meta-analysis by the European Lung Cancer Working Party for the International Association for the Study of Lung Cancer Staging Project. J Thorac Oncol: Offic Publ Int Assoc Stud Lung Canc 2010,5(5):612-619.CrossRef
4.
Onishi H, Shirato H, Nagata Y, et al.: Hypofractionated stereotactic radiotherapy (HypoFXSRT) for stage I non-small cell lung cancer: updated results of 257 patients in a Japanese multi-institutional study. J Thorac Oncol: Offic Publ Int Assoc Stud Lung Canc 2007,2(7 Suppl 3):S94-S100.CrossRef
5.
Timmerman R, Paulus R, Galvin J, et al.: Stereotactic body radiation therapy for inoperable early stage lung cancer. JAMA: J Am Med Assoc 2010,303(11):1070-1076. 10.1001/jama.2010.261CrossRef
6.
Clarke K, Taremi M, Dahele M, et al.: Stereotactic body radiotherapy (SBRT) for non-small cell lung cancer (NSCLC): is FDG-PET a predictor of outcome? Radiother Oncol: J Eur Soc Ther Radiol Oncol 2012,104(1):62-66. 10.1016/j.radonc.2012.04.019CrossRef
7.
Hamamoto Y, Sugawara Y, Inoue T, et al.: Relationship between pretreatment FDG uptake and local control after stereotactic body radiotherapy in stage I non-small-cell lung cancer: the preliminary results. Jpn J Clin Oncol 2011,41(4):543-547. 10.1093/jjco/hyq249CrossRefPubMed
8.
Takeda A, Yokosuka N, Ohashi T, et al.: The maximum standardized uptake value (SUVmax) on FDG-PET is a strong predictor of local recurrence for localized non-small-cell lung cancer after stereotactic body radiotherapy (SBRT). Radiother Oncol: J Eur Soc Ther Radiol Oncol 2011,101(2):291-297. 10.1016/j.radonc.2011.08.008CrossRef
9.
Burdick MJ, Stephans KL, Reddy CA, Djemil T, Srinivas SM, Videtic GM: Maximum standardized uptake value from staging FDG-PET/CT does not predict treatment outcome for early-stage non-small-cell lung cancer treated with stereotactic body radiotherapy. Int J Radiat Oncol Biol Phys 2010,78(4):1033-1039. 10.1016/j.ijrobp.2009.09.081CrossRefPubMed
10.
Hoopes DJ, Tann M, Fletcher JW, et al.: FDG-PET and stereotactic body radiotherapy (SBRT) for stage I non-small-cell lung cancer. Lung Canc 2007,56(2):229-234. 10.1016/j.lungcan.2006.12.009CrossRef
11.
Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A (Eds): AJCC cancer staging manual (7th ed). New York, NY: Springer; 2010.
12.
Eisenhauer EA, Therasse P, Bogaerts J, et al.: New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Canc 2009,45(2):228-247. 10.1016/j.ejca.2008.10.026CrossRef
13.
Radiation Therapy Oncology Group: Radiation Therapy Oncology Group 1021 Protocol. 2012.
14.
Detterbeck FC, Vansteenkiste JF, Morris DE, Dooms CA, Khandani AH, Socinski MA: Seeking a home for a PET, part 3: emerging applications of positron emission tomography imaging in the management of patients with lung cancer. Chest 2004,126(5):1656-1666. 10.1378/chest.126.5.1656CrossRefPubMed
15.
Sasaki R, Komaki R, Macapinlac H, et al.: [18F]fluorodeoxyglucose uptake by positron emission tomography predicts outcome of non-small-cell lung cancer. J Clin Oncol: Offic J Am Soc Clin Oncol 2005,23(6):1136-1143. 10.1200/JCO.2005.06.129CrossRef
16.
Vesselle H, Salskov A, Turcotte E, et al.: Relationship between non-small cell lung cancer FDG uptake at PET, tumor histology, and Ki-67 proliferation index. J Thorac Oncol: Offic Publ Int Assoc Stud Lung Canc 2008,3(9):971-978.CrossRef
17.
Vesselle H, Schmidt RA, Pugsley JM, et al.: Lung cancer proliferation correlates with [F-18]fluorodeoxyglucose uptake by positron emission tomography. Clin Canc Res: Offic J Am Assoc Canc Res 2000,6(10):3837-3844.
18.
Martin B, Paesmans M, Mascaux C, et al.: Ki-67 expression and patients survival in lung cancer: systematic review of the literature with meta-analysis. Brit J Canc 2004,91(12):2018-2025. 10.1038/sj.bjc.6602233CrossRef
19.
Woo T, Okudela K, Yazawa T, et al.: Prognostic value of KRAS mutations and Ki-67 expression in stage I lung adenocarcinomas. Lung Canc 2009,65(3):355-362. 10.1016/j.lungcan.2008.11.020CrossRef
20.
Mehdi SA, Tatum AH, Newman NB, et al.: Prognostic markers in resected stage I and II non small-cell lung cancer: an analysis of 260 patients with 5 year follow-up. Clin Lung Canc 1999,1(1):59-67. discussion 68-59 10.3816/CLC.1999.n.004CrossRef
21.
Ikushima H, Dong L, Erasmus J, et al.: Predictive value of 18 F-fluorodeoxyglucose uptake by positron emission tomography for non-small cell lung cancer patients treated with radical radiotherapy. J Radiat Res 2010,51(4):465-471. 10.1269/jrr.10024CrossRefPubMed
22.
Soret M, Bacharach SL, Buvat I: Partial-volume effect in PET tumor imaging. J Nucl Med: Offic Publ Soc Nucl Med 2007,48(6):932-945.CrossRef
23.
Abelson JA, Murphy JD, Trakul N, et al.: Metabolic imaging metrics correlate with survival in early stage lung cancer treated with stereotactic ablative radiotherapy. Lung Canc 2012,78(3):219-224. 10.1016/j.lungcan.2012.08.016CrossRef
Metadata
Title
Pretreatment SUVmax predicts progression-free survival in early-stage non-small cell lung cancer treated with stereotactic body radiation therapy
Authors
Zachary D Horne
David A Clump
John A Vargo
Samir Shah
Sushil Beriwal
Steven A Burton
Annette E Quinn
Matthew J Schuchert
Rodney J Landreneau
Neil A Christie
James D Luketich
Dwight E Heron
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2014
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/1748-717X-9-41

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