Relationship Between PET/CT Response and  Survival in Patients with Non-Small-Cell  Lung Cancer Treated with Definitive  Chemoradiotherapy

Sarihan, Sureyya; Sigirli, Deniz; belge, gökçe

doi:10.4999/uhod.214343

Relationship Between PET/CT Response and Survival in Patients with Non-Small-Cell Lung Cancer Treated with Definitive Chemoradiotherapy

Süreyya SARIHAN, (Uludağ Üniversitesi, Tıp Fakültesi, Radyasyon Onkolojisi Anabilim Dalı, Bursa, Türkiye)

gökçe belge, (Uludağ Üniversitesi, Tıp Fakültesi, Nükleer Tıp Anabilim Dalı, Bursa, Türkiye)

Deniz SIĞIRLI (Uludağ Üniversitesi, Tıp Fakültesi, Biyoistatistik Anabilim Dalı, Bursa, Türkiye)

Uluslararası Hematoloji-Onkoloji Dergisi

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Yıl: 2021 Cilt: 31 Sayı: 1 Sayfa Aralığı: 8 - 18 Metin Dili: İngilizce DOI: 10.4999/uhod.214343 İndeks Tarihi: 01-06-2023

Relationship Between PET/CT Response and Survival in Patients with Non-Small-Cell Lung Cancer Treated with Definitive Chemoradiotherapy

Öz:

We aimed to evaluate the relationship between PET/CT response and survival in patients with non-small cell lung cancer (NSCLC) treated with curative chemoradiotherapy. Between January and December 2012, 51 patients were treated. The median age was 61 (29-79) and the M/F ratio was 46/5. Eighty two percent of the cases were stage III and 53% were squamous cell carcinoma. Median 6300 cGy (4860-7525) radiotherapy delivered and 92% of patients received chemotherapy. The median follow-up was 27 months (7-96 months) in November 2019. The objective response was 71% with CT at 1 month and 76% with PET/CT at 3 months. There was a significant correlation between response-1 and response-3 (p< 0.001). Tumor SUVmean3 < 2.81, SUVmax change ≥ 70% was associated with response-1 (p< 0.05). The median and 5-year overall (OS) and progression-free (PFS) survival rates were 54 months, 40% and 35 months, 38%, respectively. In Cox model, for each 1 unit increase, SUVmeanbase (HR: 1.18, 95% CI: 1.01-1.38) and SU Vmean3 (HR: 2.65, 95% CI: 1.24-5.66) were found unfavorable factors for OS, whereas SUVmean3 (HR: 2.01, 95% CI: 1.02-3.93) was also found to be a poor prognostic factor for PFS. PET/CT parameters can be used as useful markers for prognosis in patients with NSCLC undergoing curative chemoradiotherapy. It is believed that early assessment during and after treatment can be advantageous in terms of treatment modification.

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Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Rengan R, Chetty IJ, Decker R, Langer CJ, O’Meara WP and Movsas B (eds). Lung cancer. In: Halperin EC, Wazer DE, Perez CA, Brady LW, eds. Principles and Practice of Radia tion Oncology, 6th ed. Philadelphia: LWW, 2013: 973-995.
2. Curran WJ Jr, Paulus R, Langer CJ, et al. Sequential vs. con current chemoradiation for stage III non-small cell lung can cer: randomized phase III trial RTOG 9410. J Natl Cancer Inst 103: 1452-1460, 2011.
3. Auperin A, Le Pechoux C, Rolland E, et al. Meta-analysis of concomitant versus sequential radiochemotherapy in locally advanced non-small-cell lung cancer. J Clin Oncol 28: 2181- 2190, 2010.
4. Perez CA, Stanley K, Rubin P, et al. A prospective randomized study of various radiation doses and fractionation schedules in the treatment of inoperable non-oat-cell carcinoma of the lung: Pre-liminary report by the Radiation Therapy Oncology Group. Cancer 45: 2744-2753, 1980.
5. Langendijk HA, Lamers RJ, ten Velde GP, et al. Is the chest radio-graph a reliable tool in the assessmant of tumour re sponse after radiotherapy in nonsmall cell lung carcinoma? Int J Radiat Oncol Biol Phys 41: 1037-1045, 1998.
6. Werner-Wasik M, Xiao Y, Pequignot E, et al. Assessment of lung cancer re-sponse after nonoperative therapy: tumour diameter, bidimensional product, and volume. A serial CT scan-based study. Int J Radiat Oncol Biol Phys 51: 56-61, 2001.
7. Warburg O. On the origin of cancer cells. Science 123: 309- 314, 1956.
8. Pieterman RM, van Putten JW, Meuzelaar JJ, et al. pre-op erative staging of non-small- cell lung cancer with positron emission tomography. N Engl J Med 343: 254-261, 2000.
9. Lardinois D, Weder W, Hany TF, et al. Staging of non-small cell lung cancer with integrated positron-emission tomog raphy and computed tomograpy. N Eng J Med 348: 2500- 2507, 2003.
10. Gould MK, Kuschner WG, Rydzak CE, et al. Test perfor mance of positron emission tomography and computed tomography for mediastinal staging in patients with non small-cell lung cancer: a meta-analysis. Ann Intern Med 139: 879-892, 2003.
11. Mac Manus MP, Hicks RJ, Matthews JP, et al. Positron emis sion tmograpy is superior to computed tomography scanning for response-assessment after radical radiotherapy or chem oradiotherapy in patients with non-small-cell lung cancer. J Clin Oncol 21: 1285-1292, 2003.
12. Bradley J, Bae K, Choi N, et al. A phase II comparative study of gross tumour volume definition with or without PET/CT fusion in dosimetric planning for non-small-cell lung cancer (NSCLC): primary analysis of Radiation Therapy Oncology Group (RTOG) 0515. Int J Radiat Oncol Biol Phys 82: 435- 441, 2012.
13. Ung YC, Gu CS, Cline K, et al. An Ontario Clinical Oncology Group (OCOG) randomized trial of FDG PET/CT in patients with stage 3 non-small cell lung cancer (NSCLC): impact of PET on radiation treatment volumes. Abstract presented at the 14th World Conference on Lung Cancer; 2011, J Thorac Oncol, 6 (6), Suppl. 2.
14. de Cabanyes Candela S, Detterbeck FC. A systematic review of restaging after induction thera-py for stage IIIa lung cancer: prediction of pathologic stage. J Thorac Oncol 5: 389-398, 2010.
15. Na F, Wang J, Li C, et al. Primary tumour standardized up take value meas-ured on F18-Fluorodeoxyglucose positron emission tomography is of prediction value for survival and local control in non-small-cell lung cancer receiving radio therapy: meta-analysis. J Thorac Oncol 9: 834-842, 2014.
16. Wahl RL, Jacene H, Kasamon Y, Lodge MA. From RECIST to PERCIST: Evolving consider-ations for PET response criteria in solid tumors. J Nucl Med 50 (Suppl 1): 122S-150S, 2009.
17. Cerfolio RJ, Bryant AS, Winokur TS, et al. Repeat FDG PET after neoadju-vant therapy is a predictor of pathologic response in patients with non-small cell lung cancer. Ann Thorac Surg 78: 1903-1909, 2004.
18. Eschmann SM, Friedel G, Paulsen F, et al. Repeat 18F-FDG PET for monitoring neoadjuvant chemotherapy in patients with stage III non-small cell lung cancer. Lung Cancer 55: 165-171, 2007.
19. Eschmann SM, Friedel G, Paulsen F, et al. 18F-FDG PET for assessment of therapy response and preoperative re evaluation after neoadjuvant radio-chemotherapy in stege III non-small cell lung cancer. Eur J Nucl Med Mol imaging 34: 463-471, 2007.
20. Machtay M, Duan F, Siegel BA, et al. predicition of survival by [18F] Fluorodeoxyglucose positron emission tomography in patients with locally ad-vanced non-small-cell lung cancer undergoing definitive chemoradiation therapy: results of the ACRIN 6668/RTOG 0235 trial. J Clin Oncol 31: 3823-3830, 2013.
21. Common Terminology Criteria for Adverse Events v4. htt ps://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03/CTCAE_607 4.03_2010-06-14_QuickReference_8.5x11.pdf
22. Kong FM, Haken RKT, Schipper MJ, et al. High-dose radia tion improved local tumour control and overall survival in pa tients with inopera-ble/unresectable non-small-cell lung can cer: long-term results of a radiation dose escalation study. Int J Radiat Oncol Biol Phys 63: 324-333, 2005.
23. Martini N, Kris MG, Flehinger BJ, et al. Preoperative chemo therapy for stage IIIa (N2) lung cancer: the Sloan-kettering ex perience with 136 patients. Ann Thorac Surg 55: 1365-1373, 1993.
24. Higgins K, Chino JP, Marks LB, et al. Preoperative chem otehrapy versus preoperative chemoradiotherapy for stage III (N2) non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 75: 1462-1467, 2009.
25. Albain KS, Swann RS, Rusch VW, et al. Radiotherapy plus chemotherapy with or without surgical resection for stage III non-small-cell lung cancer: a phase III randomised controlled trial. Lancet 374: 379-386, 2009.
26. Chaft JE, Dunphy M, Naidoo J, et al. Adaptive neoadjuvant chemotherapy guided by (18)F-FDG PET in resectable non small cell lung cancers: The NE-OSCAN trial. J Thorac Oncol 11: 537-544, 2016.
27. Lee HY, Lee HJ, Kim YT, et al. Value of combined interpre tation of computed tomography response and positron emis sion tomography response for predic-tion of prognosis after neoadjuvant chemotherapy in non-small cell lung cancer. J Thorac Oncol 5: 497-503, 2010.
28. Iravani A, Turgeon GA, Akhurst T, et al. PET-detected pneu monitis following curative-intent chemoradiation in non-small cell lung cancer (NSCLC): rec-ognizing patterns and assess ing the impact on the predictive ability of FDG-PET/CT re sponse as-sessment. Eur J Nucl Med Mol Imaging 46: 1869- 1877, 2019.
29. Chen HHW, Su WC, Guo HR, et al. Prognostic value of volu metric metabolic parameter changes determined by during and after radiotherapy-based 18F-FDG PET/CT in stage III non-small cell lung cancer. Kaohsiung J Med Sci 35: 151- 159, 2019.
30. van Elmpt W, De Ruysscher D, van der Salm A, et al. The PET-boost randomised phase II dose-escalation trial in non small cell lung cancer. Radiother Oncol 104: 67-71, 2012.
31. van Loon J, Grutters J, Wanders R, et al. Follow-up with 18FDG-PET-CT after radical radiotherapy with or without chemotherapy allows the detection of potentially curable progressive disease in non-small cell lung cancer patients: a prospective study. Eur J Cancer 45: 588-595, 2009.
32. Allen-Auerbach M, Weber WA. Measuring response with FDG-PET: methodological aspects. Oncologist 14: 369-377, 2009.
33. Salavati A, Duan F, Snyder BS, et al. Optimal FDG PET/CT volumetric parameters for risk stratification in patients with lo cally advanced non-small cell lung cancer: results from the ACRIN 6668/RTOG 0235 trial. Eur J Nucl Med Mol Imaging 44: 1969-1983, 2017.
34. Choi NC, Fischman AJ, Niemierko A, et al. Dose-response relation-ship between probability of pathologic tumour control and glucose metabolic rate measured with FDG PET after preoperative chemoradiotherapy in locally advanced non small-cell lung cancer. Int J Radiat Oncol Biol Phys 54: 1024- 35, 2002.
35. Massaccesi M, Calcagni ML, Spitilli MG, et al. 18F-FDG PET CT during chemo-radiotherapy in patients with non-small cell lung cancer: the early metabolic response correlates with the delivered radiation dose. Radiat Oncol 7: 106, 2012.
36. Zhang X, Liu H, Balter P, et al. Positron emission tomography for assessing local failure after stereotactic body radiotherapy for non-small-cell lung cancer. Int J Radi-at Oncol Biol Phys 83: 1558-1565, 2012.
37. Markovina S, Duan F, Snyder BS, et al. Regional lymph node uptake of [(18)F] Fluorodeoxyglucose after definitive chemo radiation therapy predicts local-regional failure of locally ad vanced non-small cell lung cancer: Results of ACRIN 6668/ RTOG 0235. Int J Radiat Oncol Biol Phys 93: 597-605, 2015.
38. Arnett AL, Packard AT, Mara K, et al. FDG-PET parameters as predictors of pathologic response and nodal clearance in patients with stage III non-small cell lung cancer receiving neoadjuvant chemoradiation and surgery. Pract Radiat Oncol 7: e531-e541, 2017.
39. Okazaki E, Seura H, Hasegawa Y, et al. Prognostic value of the volumetric parameters of dual-time point 18F-FDG PET/ CT in non-small cell lung cancer treated with definitive radia tion therapy. Am J Roentgenol 213: 1366-1373, 2019.
40. van Loon J, Offermann C, Ollers M, et al. Early CT and FDG metabolic tumour volume changes show a significant correla tion with survival in stage I-III small cell lung cancer: a hypoth esis generating study. Radiother Oncol 99: 172-175, 2011.
41. Huang W, Fan M, Liu B, et al. Value of metabolic tumour volume on repeated 18F-FDG PET/CT for early prediction of survival in locally advanced non-small cell lung cancer treated with concurrent chemoradiotherapy. J Nucl Med 55: 1584- 1590, 2014.
42. van Diessen JNA, La Fontaine M, van den Heuvel MM, et al. Local and regional treatment response by 18FDG-PET CT-scans 4 weeks after concurrent hypofractionated chemo radiotherapy in locally advanced NSCLC. Radiother Oncol S0167-8140(19)33144-5, 2019.
43. Marks LB, Bentzen SM, Deasy JO, et al. Radiation dose volume effects in the lung. Int J Radiat Oncol Biol Phys 76 (3 Suppl): S70-76, 2010.
44. Liao ZX, Komaki RR, Thames HD Jr, et al. Influence of tech nologic advances on outcomes in patients with unresectable, locally advanced non-small-cell lung cancer receiving con comitant chemoradiotherapy. Int J Radiat Oncol Biol Phys 76: 775-781, 2010.
45. Okumus D, Sarihan S, Gozcu S, Sigirli D. The relationship between dosimetric factors, side effects, and survival in pa tients with non-small cell lung cancer treated with definitive radiotherapy. Med Dosim 42: 169-176, 2017.
46. Warner A, Dahele M, Hu B, et al. Factors associated with ear ly mortality in patients treated with concurrent chemoradiation therapy for locally advanced non-small cell lung cancer. Int J Radiat Oncol Biol Phys 94: 612-620, 2016.

APA	Sarihan S, belge g, Sigirli D (2021). Relationship Between PET/CT Response and Survival in Patients with Non-Small-Cell Lung Cancer Treated with Definitive Chemoradiotherapy. , 8 - 18. 10.4999/uhod.214343
Chicago	Sarihan Sureyya,belge gökçe,Sigirli Deniz Relationship Between PET/CT Response and Survival in Patients with Non-Small-Cell Lung Cancer Treated with Definitive Chemoradiotherapy. (2021): 8 - 18. 10.4999/uhod.214343
MLA	Sarihan Sureyya,belge gökçe,Sigirli Deniz Relationship Between PET/CT Response and Survival in Patients with Non-Small-Cell Lung Cancer Treated with Definitive Chemoradiotherapy. , 2021, ss.8 - 18. 10.4999/uhod.214343
AMA	Sarihan S,belge g,Sigirli D Relationship Between PET/CT Response and Survival in Patients with Non-Small-Cell Lung Cancer Treated with Definitive Chemoradiotherapy. . 2021; 8 - 18. 10.4999/uhod.214343
Vancouver	Sarihan S,belge g,Sigirli D Relationship Between PET/CT Response and Survival in Patients with Non-Small-Cell Lung Cancer Treated with Definitive Chemoradiotherapy. . 2021; 8 - 18. 10.4999/uhod.214343
IEEE	Sarihan S,belge g,Sigirli D "Relationship Between PET/CT Response and Survival in Patients with Non-Small-Cell Lung Cancer Treated with Definitive Chemoradiotherapy." , ss.8 - 18, 2021. 10.4999/uhod.214343
ISNAD	Sarihan, Sureyya vd. "Relationship Between PET/CT Response and Survival in Patients with Non-Small-Cell Lung Cancer Treated with Definitive Chemoradiotherapy". (2021), 8-18. https://doi.org/10.4999/uhod.214343

APA	Sarihan S, belge g, Sigirli D (2021). Relationship Between PET/CT Response and Survival in Patients with Non-Small-Cell Lung Cancer Treated with Definitive Chemoradiotherapy. Uluslararası Hematoloji-Onkoloji Dergisi, 31(1), 8 - 18. 10.4999/uhod.214343
Chicago	Sarihan Sureyya,belge gökçe,Sigirli Deniz Relationship Between PET/CT Response and Survival in Patients with Non-Small-Cell Lung Cancer Treated with Definitive Chemoradiotherapy. Uluslararası Hematoloji-Onkoloji Dergisi 31, no.1 (2021): 8 - 18. 10.4999/uhod.214343
MLA	Sarihan Sureyya,belge gökçe,Sigirli Deniz Relationship Between PET/CT Response and Survival in Patients with Non-Small-Cell Lung Cancer Treated with Definitive Chemoradiotherapy. Uluslararası Hematoloji-Onkoloji Dergisi, vol.31, no.1, 2021, ss.8 - 18. 10.4999/uhod.214343
AMA	Sarihan S,belge g,Sigirli D Relationship Between PET/CT Response and Survival in Patients with Non-Small-Cell Lung Cancer Treated with Definitive Chemoradiotherapy. Uluslararası Hematoloji-Onkoloji Dergisi. 2021; 31(1): 8 - 18. 10.4999/uhod.214343
Vancouver	Sarihan S,belge g,Sigirli D Relationship Between PET/CT Response and Survival in Patients with Non-Small-Cell Lung Cancer Treated with Definitive Chemoradiotherapy. Uluslararası Hematoloji-Onkoloji Dergisi. 2021; 31(1): 8 - 18. 10.4999/uhod.214343
IEEE	Sarihan S,belge g,Sigirli D "Relationship Between PET/CT Response and Survival in Patients with Non-Small-Cell Lung Cancer Treated with Definitive Chemoradiotherapy." Uluslararası Hematoloji-Onkoloji Dergisi, 31, ss.8 - 18, 2021. 10.4999/uhod.214343
ISNAD	Sarihan, Sureyya vd. "Relationship Between PET/CT Response and Survival in Patients with Non-Small-Cell Lung Cancer Treated with Definitive Chemoradiotherapy". Uluslararası Hematoloji-Onkoloji Dergisi 31/1 (2021), 8-18. https://doi.org/10.4999/uhod.214343