Prognostic value of volumetric metabolic parameter changes determined by during and after radiotherapy-based 18F-FDG PET/CT in stage III non-small cell lung cancer

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Abstract

The aim of this prospective study was to evaluate the prognostic value of volumetric metabolic parameters assessed by during and after radiation-based therapy 18F-FDG PET/CT in patients with stage III non-small cell lung cancer (NSCLC). We enrolled stage III NSCLC patients who had planned to receive definitive chemo-radiation or radiotherapy (RT) and underwent 18F-FDG PET/CT before treatment (PET1), during RT (at the fifth week, PET2) and after treatment (3 months later, PET3). By comparing with PET1, percentage changes of metabolic tumor volume (ΔMTV) and tumor total lesion glycolysis (ΔTLG) of PET2 and PET3 were calculated. We used medians of ΔTLG and ΔMTV as cut-off values to stratify patients. Their prognostic values were evaluated by progression-free survival (PFS) and overall survival (OS). Thirty patients were enrolled initially. Five were excluded due to multiple metastases or double cancer. The remaining 25 patients had PET2 at a median of 46 Gy. Data on PET3 were available in 19 patients. During-RT ΔTLG (cut-off: 65%) was a significant prognostic factor for PFS (P = 0.02) and OS (P < 0.01). During-RT ΔMTV (cut-off: 42%) had marginal significance for PFS (P = 0.07) and was significant for OS (P = 0.02). Of the PET3 parameters, neither ΔTLG nor ΔMTV was a significant prognostic factor for PFS and OS. We conclude that ΔTLG of during-RT 18F-FDG PET/CT may predict treatment response and thus provide opportunities to modify treatment for poor responders.

Original languageEnglish
Pages (from-to)151-159
Number of pages9
JournalKaohsiung Journal of Medical Sciences
Volume35
Issue number3
DOIs
Publication statusPublished - 2019 Jan 1

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Fluorodeoxyglucose F18
Non-Small Cell Lung Carcinoma
Glycolysis
Radiotherapy
Tumor Burden
Disease-Free Survival
Survival
Therapeutics
Neoplasms
Prospective Studies
Radiation
Neoplasm Metastasis

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

@article{6eec65e82ce54c908b47e49742c2d098,
title = "Prognostic value of volumetric metabolic parameter changes determined by during and after radiotherapy-based 18F-FDG PET/CT in stage III non-small cell lung cancer",
abstract = "The aim of this prospective study was to evaluate the prognostic value of volumetric metabolic parameters assessed by during and after radiation-based therapy 18F-FDG PET/CT in patients with stage III non-small cell lung cancer (NSCLC). We enrolled stage III NSCLC patients who had planned to receive definitive chemo-radiation or radiotherapy (RT) and underwent 18F-FDG PET/CT before treatment (PET1), during RT (at the fifth week, PET2) and after treatment (3 months later, PET3). By comparing with PET1, percentage changes of metabolic tumor volume (ΔMTV) and tumor total lesion glycolysis (ΔTLG) of PET2 and PET3 were calculated. We used medians of ΔTLG and ΔMTV as cut-off values to stratify patients. Their prognostic values were evaluated by progression-free survival (PFS) and overall survival (OS). Thirty patients were enrolled initially. Five were excluded due to multiple metastases or double cancer. The remaining 25 patients had PET2 at a median of 46 Gy. Data on PET3 were available in 19 patients. During-RT ΔTLG (cut-off: 65{\%}) was a significant prognostic factor for PFS (P = 0.02) and OS (P < 0.01). During-RT ΔMTV (cut-off: 42{\%}) had marginal significance for PFS (P = 0.07) and was significant for OS (P = 0.02). Of the PET3 parameters, neither ΔTLG nor ΔMTV was a significant prognostic factor for PFS and OS. We conclude that ΔTLG of during-RT 18F-FDG PET/CT may predict treatment response and thus provide opportunities to modify treatment for poor responders.",
author = "Chen, {Helen H.W} and Wu-Chou Su and How-Ran Guo and Bi-Fang Lee and Nan-Tsing Chiu",
year = "2019",
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language = "English",
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T1 - Prognostic value of volumetric metabolic parameter changes determined by during and after radiotherapy-based 18F-FDG PET/CT in stage III non-small cell lung cancer

AU - Chen, Helen H.W

AU - Su, Wu-Chou

AU - Guo, How-Ran

AU - Lee, Bi-Fang

AU - Chiu, Nan-Tsing

PY - 2019/1/1

Y1 - 2019/1/1

N2 - The aim of this prospective study was to evaluate the prognostic value of volumetric metabolic parameters assessed by during and after radiation-based therapy 18F-FDG PET/CT in patients with stage III non-small cell lung cancer (NSCLC). We enrolled stage III NSCLC patients who had planned to receive definitive chemo-radiation or radiotherapy (RT) and underwent 18F-FDG PET/CT before treatment (PET1), during RT (at the fifth week, PET2) and after treatment (3 months later, PET3). By comparing with PET1, percentage changes of metabolic tumor volume (ΔMTV) and tumor total lesion glycolysis (ΔTLG) of PET2 and PET3 were calculated. We used medians of ΔTLG and ΔMTV as cut-off values to stratify patients. Their prognostic values were evaluated by progression-free survival (PFS) and overall survival (OS). Thirty patients were enrolled initially. Five were excluded due to multiple metastases or double cancer. The remaining 25 patients had PET2 at a median of 46 Gy. Data on PET3 were available in 19 patients. During-RT ΔTLG (cut-off: 65%) was a significant prognostic factor for PFS (P = 0.02) and OS (P < 0.01). During-RT ΔMTV (cut-off: 42%) had marginal significance for PFS (P = 0.07) and was significant for OS (P = 0.02). Of the PET3 parameters, neither ΔTLG nor ΔMTV was a significant prognostic factor for PFS and OS. We conclude that ΔTLG of during-RT 18F-FDG PET/CT may predict treatment response and thus provide opportunities to modify treatment for poor responders.

AB - The aim of this prospective study was to evaluate the prognostic value of volumetric metabolic parameters assessed by during and after radiation-based therapy 18F-FDG PET/CT in patients with stage III non-small cell lung cancer (NSCLC). We enrolled stage III NSCLC patients who had planned to receive definitive chemo-radiation or radiotherapy (RT) and underwent 18F-FDG PET/CT before treatment (PET1), during RT (at the fifth week, PET2) and after treatment (3 months later, PET3). By comparing with PET1, percentage changes of metabolic tumor volume (ΔMTV) and tumor total lesion glycolysis (ΔTLG) of PET2 and PET3 were calculated. We used medians of ΔTLG and ΔMTV as cut-off values to stratify patients. Their prognostic values were evaluated by progression-free survival (PFS) and overall survival (OS). Thirty patients were enrolled initially. Five were excluded due to multiple metastases or double cancer. The remaining 25 patients had PET2 at a median of 46 Gy. Data on PET3 were available in 19 patients. During-RT ΔTLG (cut-off: 65%) was a significant prognostic factor for PFS (P = 0.02) and OS (P < 0.01). During-RT ΔMTV (cut-off: 42%) had marginal significance for PFS (P = 0.07) and was significant for OS (P = 0.02). Of the PET3 parameters, neither ΔTLG nor ΔMTV was a significant prognostic factor for PFS and OS. We conclude that ΔTLG of during-RT 18F-FDG PET/CT may predict treatment response and thus provide opportunities to modify treatment for poor responders.

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U2 - 10.1002/kjm2.12027

DO - 10.1002/kjm2.12027

M3 - Article

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JO - Kaohsiung Journal of Medical Sciences

JF - Kaohsiung Journal of Medical Sciences

SN - 1607-551X

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