Maximum Standardized Uptake Value From Staging FDG-PET/CT Does not Predict Treatment Outcome for Early-Stage Non-Small-Cell Lung Cancer Treated With Stereotactic Body Radiotherapy

Journal Article · Mon Nov 15 04:00:00 EST 2010 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.09.081· OSTI ID:21438038

Burdick, Michael J; Stephans, Kevin L; Reddy, Chandana A; Djemil, Toufik ^[1]; Srinivas, Shyam M ^[2]

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1. Department of Radiation Oncology, Cleveland Clinic, Cleveland, OH (United States)
2. Department of Nuclear Medicine, Cleveland Clinic, Cleveland, OH (United States)

Purpose: To perform a retrospective review to determine whether maximum standardized uptake values (SUV{sub max}) from staging 2-deoxy-2- [{sup 18}F] fluoro-D-glucose (FDG) positron emission tomography/computed tomography (PET/CT) studies are associated with outcomes for early-stage non-small-cell lung cancer (NSCLC) treated with stereotactic body radiotherapy (SBRT). Methods and Materials: Seventy-two medically inoperable patients were treated between October 17, 2003 and August 17, 2007 with SBRT for T1-2N0M0 NSCLC. SBRT was administered as 60 Gy in 3 fractions, 50 Gy in 5 fractions, or 50 Gy in 10 fractions using abdominal compression and image-guided SBRT. Cox proportional hazards regression was performed to determine whether PET SUV{sub max} and other variables influenced outcomes: mediastinal failure (MF), distant metastases (DM), and overall survival (OS). Results: Biopsy was feasible in 49 patients (68.1%). Forty-nine patients had T1N0 disease, and 23 had T2N0 disease. Median SUV{sub max} was 6.55 (range, 1.5-21). Median follow-up was 16.9 months (range, 0.1-37.9 months). There were 3 local failures, 8 MF, 19 DM, and 30 deaths. Two-year local control, MF, DM, and OS rates were 94.0%, 10.4%, 30.1%, and 61.3%, respectively. In univariate analysis, PET/CT SUV{sub max}, defined either as a continuous or dichotomous variable, did not predict for MF, DM, or OS. On multivariable analysis, the only predictors for overall survival were T1 stage (hazard ratio = 0.331 [95% confidence interval, 0.156-0.701], p = 0.0039) and smoking pack-year history (hazard ratio = 1.015 [95% confidence interval, 1.004-1.026], p = 0.0084). Conclusions: Pretreatment PET SUV{sub max} did not predict for MF, DM, or OS in patients treated with SBRT for early-stage NSCLC.

• OSTI ID: 21438038
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 4 Vol. 78; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

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DIAGNOSTIC TECHNIQUES
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