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European Journal of Nuclear Medicine and Molecular Imaging

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Open Access 01-05-2020 | NSCLC | Original Article

Prognostic significance of semi-quantitative FDG-PET parameters in stage I non-small cell lung cancer treated with carbon-ion radiotherapy

Authors: Suman Shrestha, Tetsuya Higuchi, Katsuyuki Shirai, Azusa Tokue, Shreya Shrestha, Jun-ichi Saitoh, Hiromi Hirasawa, Tatsuya Ohno, Takashi Nakano, Yoshito Tsushima

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 5/2020

Abstract

Purpose

Prognostic significance of volumetric ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography/computer tomography (PET/CT) parameters in carbon-ion radiotherapy (C-ion RT) treated stage I non-small cell lung cancer, and need of histology-wise separate cut-off values for risk stratification were assessed.

Methods

Thirty-nine patients (29 men and 10 women, 71.9 ± 8.3 years) who underwent FDG PET/CT examinations before C-ion RT were retrospectively evaluated. FDG-PET parameters: standardized uptake values (SUVmax, SUVpeak, and SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), and clinicopathological variables were assessed for prognosis using Cox proportional hazards regression analysis. Mann-Whitney test compared medians of significant parameters between adenocarcinoma (AC) and squamous cell carcinoma (SCC), and Kaplan-Meier curves were plotted for median-based low- and high-risk groups.

Results

Median follow-up period was 44.8 months. 1/2/3-year overall survival (OS), progression-free survival (PFS) and local control (LC) rates were 94.9/84.3/70.8, 82.1/69.2/58.4 and 97.3/85.7/82.3%. Multivariate analysis revealed age (hazard ratio, HR: 1.09; 95% confidence interval, CI: 1.0–1.19, p < 0.05) and MTV (HR 4.83, 95% CI 1.21–19.27, p < 0.03) predicted OS, and only MTV predicted PFS (HR 5.3, CI 1.32–21.35, p < 0.02) independently. Compared with AC, SCC had higher MTV (median, 6.625cm³ vs 0.2 cm³, p < 0.01). Single MTV cut-off based on overall cohort was insignificant in SCC for PFS (p > 0.02); separate cut-offs of MTV, 0.2 cm³ for AC (p < 0.03) and 6.625 cm³ for SCC (p < 0.05) were relevant.

Conclusion

Among all FDG PET/CT parameters, only MTV beared prognostic ability for stage I NSCLC treated with C-ion RT, and its histological variation may need consideration for risk-adapted therapeutic management.

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Title: Prognostic significance of semi-quantitative FDG-PET parameters in stage I non-small cell lung cancer treated with carbon-ion radiotherapy
Authors: Suman Shrestha
Tetsuya Higuchi
Katsuyuki Shirai
Azusa Tokue
Shreya Shrestha
Jun-ichi Saitoh
Hiromi Hirasawa
Tatsuya Ohno
Takashi Nakano
Yoshito Tsushima
Publication date: 01-05-2020
Publisher: Springer Berlin Heidelberg
Keywords: NSCLC
NSCLC
Radiotherapy
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 5/2020
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-019-04585-0

At a glance: The STEP trials

Springer Medicine

Prognostic significance of semi-quantitative FDG-PET parameters in stage I non-small cell lung cancer treated with carbon-ion radiotherapy

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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