Radiat Oncol J.  2013 Sep;31(3):111-117. 10.3857/roj.2013.31.3.111.

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

• Kang HC
• Wu HG
• Yu T
• Kim HJ
• Paeng JC

• KMID: 2051126
• DOI: http://doi.org/10.3857/roj.2013.31.3.111

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 < or = 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] < or = 1) and mSUVR < or = 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.

Keyword

Non-small-cell lung carcinoma; Radiotherapy; Positron-emission tomography; Prognosis

MeSH Terms

Carcinoma, Non-Small-Cell Lung
Humans
Lymph Nodes
Multivariate Analysis
Positron-Emission Tomography
Prognosis