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Fluorodeoxyglucose positron-emission tomography ratio in non-small cell lung cancer patients treated with definitive radiotherapy

Radiation Oncology Journal
2013년 31권 3호 p.111 ~ p.117
강현철 ( Kang Hyun-Cheol ) - Seoul National University College of Medicine Department of Radiation Oncology

우홍균 ( Wu Hong-Gyun ) - Seoul National University College of Medicine Department of Radiation Oncology
 ( Yu To-Sol ) - Seoul National University College of Medicine Department of Radiation Oncology
김학재 ( Kim Hak-Jae ) - Seoul National University College of Medicine Department of Radiation Oncology
팽진철 ( Paeng Jin-Chul ) - Seoul National University College of Medicine Cancer Research Institute

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 ≤ 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] ≤ 1) and mSUVR ≤ 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. Keywords: Non-small-cell lung carcinoma, Radiotherapy, Positron-emission tomography, Prognosis

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