A Pilot Trial of Serial 18F-Fluorodeoxyglucose Positron Emission Tomography in Patients With Medically Inoperable Stage I Non-Small-Cell Lung Cancer Treated With Hypofractionated Stereotactic Body Radiotherapy

Journal Article · Mon Mar 01 00:00:00 EST 2010 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.02.051· OSTI ID:21372102

Hoopes, David J ^[1]; Fletcher, James W; Lin, P -F; Tann, Mark ^[2]; Yiannoutsos, Constantin T ^[3]; Williams, Mark D ^[4]; Fakiris, Achilles J ^[1]; McGarry, Ronald C ^[5]; Timmerman, Robert D ^[6]

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1. Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN (United States)
2. Department of Nuclear Medicine, Indiana University School of Medicine, Indianapolis, IN (United States)
3. Division of Biostatistics, Indiana University School of Medicine, Indianapolis, IN (United States)
4. Pulmonary Division, Richard L. Roudebush Veterans Administration Medical Center, Indianapolis, IN (United States)
5. Department of Radiation Medicine, University of Kentucky, Lexington, KY (United States)
6. Department of Radiation Oncology, University of Texas Southwestern Medical Center at Dallas, Dallas, TX (United States)

Purpose: Routine assessment was made of tumor metabolic activity as measured by 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in Stage I non-small-cell lung cancer (NSCLC). This report describes PET correlates prospectively collected after stereotactic body radiotherapy (SBRT) for patients with medically inoperable NSCLC. Methods and Materials: 14 consecutive patients with medically inoperable Stage I NSCLC were enrolled. All patients received SBRT to 60-66 Gy in three fractions. Patients underwent serial planned FDG-PET/computed tomography fusion imaging before SBRT and at 2, 26, and 52 weeks after SBRT. Results: With median follow-up of 30.2 months, no patients experienced local failure. One patient developed regional failure, 1 developed distant failure, and 1 developed a second primary. The median tumor maximum standardized uptake value (SUV{sub max}) before SBRT was 8.70. The median SUV{sub max} values at 2, 26, and 52 weeks after SBRT were 6.04, 2.80, and 3.58, respectively. Patients with low pre-SBRT SUV were more likely to experience initial 2-week rises in SUV, whereas patients with high pre-SBRT SUV commonly had SUV declines 2 weeks after treatment (p = 0.036). Six of 13 patients had primary tumor SUV{sub max} >3.5 at 12 months after SBRT but remained without evidence of local disease failure on further follow-up. Conclusions: A substantial proportion of patients may have moderately elevated FDG-PET SUV{sub max} at 12 months without evidence of local failure on further follow-up. Thus, slightly elevated PET SUV{sub max} should not be considered a surrogate for local treatment failure. Our data do not support routine serial FDG-PET/computed tomography for follow-up of patients receiving SBRT for Stage I NSCLC.

• OSTI ID: 21372102
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 76, Issue 3; Other Information: DOI: 10.1016/j.ijrobp.2009.02.051; PII: S0360-3016(09)00349-6; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
• Country of Publication: United States
• Language: English

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