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 00:00:00 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]

---

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, Vol. 78, Issue 4; Other Information: DOI: 10.1016/j.ijrobp.2009.09.081; PII: S0360-3016(09)03584-6; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
FLUORINE 18
FLUORODEOXYGLUCOSE
LUNGS
NEOPLASMS
POSITRON COMPUTED TOMOGRAPHY
RADIOTHERAPY
UPTAKE
ANTIMETABOLITES
BETA DECAY RADIOISOTOPES
BETA-PLUS DECAY RADIOISOTOPES
BODY
COMPUTERIZED TOMOGRAPHY
DIAGNOSTIC TECHNIQUES
DISEASES
DRUGS
EMISSION COMPUTED TOMOGRAPHY
FLUORINE ISOTOPES
HOURS LIVING RADIOISOTOPES
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
LIGHT NUCLEI
MEDICINE
NANOSECONDS LIVING RADIOISOTOPES
NUCLEAR MEDICINE
NUCLEI
ODD-ODD NUCLEI
ORGANS
RADIOISOTOPES
RADIOLOGY
RESPIRATORY SYSTEM
THERAPY
TOMOGRAPHY