Intratumoral Metabolic Heterogeneity for Prediction of Disease Progression After Concurrent Chemoradiotherapy in Patients with Inoperable Stage III Non-Small-Cell Lung Cancer |
| |
Authors: | Sae-Ryung Kang Ho-Chun Song Byung Hyun Byun Jong-Ryool Oh Hyeon-Sik Kim Sun-Pyo Hong Seong Young Kwon Ari Chong Jahae Kim Sang-Geon Cho Hee Jeong Park Young-Chul Kim Sung-Ja Ahn Jung-Joon Min Hee-Seung Bom |
| |
Institution: | 1. Department of Nuclear Medicine, Chonnam National University Hospital, Gwangju, 501-757, Republic of Korea 5. Department of Nuclear Medicine, Chonnam National University Medical School and Hospital, 42, Jebong-no, Donggu, Gwangju, 501-757, Republic of Korea 2. Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, Gwangju, Republic of Korea 3. Department of Internal Medicine, Chonnam National University Hwasun Hospital, Gwangju, Republic of Korea 4. Department of Radiation Oncology, Chonnam National University Hwasun Hospital, Gwangju, Republic of Korea
|
| |
Abstract: | PurposeWe evaluated the value of variable 18F-FDG PET/CT parameters for the prediction of disease progression after concurrent chemoradiotherapy (CCRT) in patients with inoperable stage III non-small-cell lung cancer (NSCLC).MethodsOne hundred sixteen pretreatment FDG PET/CT scans of inoperable stage III NSCLC were retrospectively reviewed (stage IIIA: 51; stage IIIB: 65). The volume of interest was automatically drawn for each primary lung tumor, and PET parameters were assessed as follows: maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) using the boundaries presenting SUV intensity exceeding 3.0, and the area under the curve of the cumulative SUV-volume histograms (AUC-CSH), which is known to reflect the tumor heterogeneity. Progression-free survival (PFS), locoregional recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were compared with each PET and clinical parameters by univariate and multivariate survival analysis.ResultsIn the ROC analysis, the optimal cutoff values of SUVmax, MTV (cm3), and AUC-CSH for prediction of PFS were determined as 21.5, 27.7, and 4,800, respectively. In univariate analysis, PFS was statistically significantly reduced in those with AUC-CSH?4,800 (p?=?0.004). In multivariate analysis, AUC-CSH and SUVmax were statistically significant independent prognostic factors (HR 3.35, 95 % CI 1.79–6.28, p?0.001; HR 0.25, 95 % CI 0.09–0.70, p?=?0.008, respectively). Multivariate analysis showed that AUC-CSH was the most significant independent prognostic factor for LRFS and DMFS (HR 3.27, 95 % CI 1.54–6.94, p?=?0.002; HR 2.79, 95 % CI 1.42–5.50, p?=?0.003).ConclusionsIntratumoral metabolic heterogeneity of primary lung tumor in 18F-FDG PET/CT can predict disease progression after CCRT in inoperable stage III NSCLC. |
| |
Keywords: | Non-small-cell lung cancer Intratumoral heterogeneity Prognosis F-18 FDG PET |
本文献已被 SpringerLink 等数据库收录! |
|