Prognostic value of SUVmax measurements obtained by FDG-PET in patients with non-small cell lung cancer receiving chemotherapy |
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Authors: | Yohei ImamuraKoichi Azuma Seiji KurataSatoshi Hattori Tetsuro SasadaTakashi Kinoshita Masaki OkamotoTomotaka Kawayama Hayato KaidaMasatoshi Ishibashi Hisamichi Aizawa |
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Affiliation: | a Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan b Department of Radiology, Kurume University School of Medicine, Kurume, Japan c Biostatistics Center, Kurume University, Kurume, Japan d Cancer Vaccine Center, Dana-Farber Cancer Institute, Boston, MA 02115, USA |
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Abstract: | [18F]Fluorodeoxyglucose (FDG) uptake has been shown to correlate well with tumor proliferation rates. In patients with non-small cell lung cancer (NSCLC) receiving chemotherapy, we analyzed the relationships between the maximum standardized uptake value (SUVmax) obtained by FDG positron emission tomography (FDG-PET) and other clinical factors, and examined whether or not SUVmax could predict progression-free survival (PFS) and/or overall survival (OS). This retrospective study involved 62 consecutive NSCLC patients (35 male and 27 female: median age, 65 years). All patients underwent FDG-PET examination before treatment. As the first-line treatment, the patients received chemotherapy with (n = 15) or without (n = 47) radiotherapy. Survival curves were obtained by the Kaplan-Meier method, and differences in survival between subgroups were analyzed by the log-rank test and the Cox proportional hazards model. Significant correlations were observed between SUVmax and gender (P = 0.006), histology (P < 0.001), smoking status (P = 0.049), stage (P = 0.015), and treatment modality (P = 0.008), but not other factors, including age (P = 0.402) and performance status (P = 0.421). The median SUVmax was 5.1 (25-75th percentile: 3.45-7.0) in patients with adenocarcinoma and 8.3 (25-75th percentile: 6.9-9.9) in those with other types of NSCLC. Adenocarcinomas showed significantly lower SUVmax than the other tumor types (P < 0.001). Cox analysis adjusting for possible confounding factors, including gender, smoking status, histology and stage, demonstrated that the hazard ratios increased as the SUVmax increased in terms of both PFS (P = 0.008) and OS (P = 0.045), indicating that SUVmax predicts outcome independently of other clinical factors, such as histology and stage. Our findings indicate that FDG-PET examination can provide information useful for prognostication in NSCLC. |
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Keywords: | NSCLC, non-small cell lung cancer FDG, [18F]fluorodeoxyglucose PET, positron emission tomography SUV, standardized uptake value SUVmax, maximum standardized uptake value PCR, polymerase chain reaction OS, overall survival PFS, progression-free survival CT, computed tomography CR, complete response PR, partial response PD, progressive disease SD, stable disease ROI, region of interest CI, confidence interval HR, hazard ratio TLG, total lesion glycolysis |
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