FDG uptake correlates with recurrence and survival after treatment of unresectable stage III non-small cell lung cancer with high-dose proton therapy and chemotherapy

• Main Authors: Xiang Zuo-Lin, Erasmus Jeremy, Komaki Ritsuko, Cox James D, Chang Joe Y
• Format: Article
• Language: English
• Published: BMC 2012-08-01
• Series: Radiation Oncology
• Subjects: Proton therapy; Chemotherapy; Non-small cell lung cancer; PET/CT imaging; Standardized uptake value; Prognostic factors
• Online Access: http://www.ro-journal.com/content/7/1/144

<p>Abstract</p> <p>Background</p> <p>We studied whether maximum standardized uptake values (SUV) from [¹⁸ F] PET/CT predict clinical outcome after concurrent proton/chemotherapy for stage III non-small cell lung cancer (NSCLC).</p> <p>Methods</p> <p>Eighty-four patients were treated prospectively with 74 Gy(RBE) proton therapy and concurrent chemotherapy. PET/CT scans were available before (SUV1) and within 6 months after (SUV2) treatment. The predictive value of clinical and PET/CT factors were analyzed with univariate and multivariate Cox regression models.</p> <p>Results</p> <p>Median survival time was 29.9 months. At 3 years, the local recurrence-free survival (LRFS) rate was 34.8%; distant metastasis-free survival (DMFS), 35.4%; progression-free survival (PFS), 31.2%; and overall survival (OS), 37.2%. Patients with SUV2 ≥3.6 (the median) had high rates of LR (<it>p</it> = 0.021). Of 12 clinicopathologic features evaluated in univariate analysis, only KPS, SUV1, and SUV2 predicted LRFS, DMFS, PFS, and OS (<it>p</it> <0.05). Multivariate analysis showed that KPS (<it>p</it> = 0.025) and SUV2 (<it>p</it> = 0.017) were independently prognostic for LRFS and that SUV1, SUV2, and KPS were independently prognostic for DMFS, PFS, and OS (<it>p</it> <0.05).</p> <p>Conclusions</p> <p>SUV2 predicted LRFS, and SUV1 and SUV2 predicted DMFS, PFS, and OS, in patients with stage III NSCLC treated with concurrent chemotherapy and high-dose proton therapy.</p>