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OtherClinical Investigations (Human)

Lack of adherence to guideline-based imaging prior to subsequent radiation in patients with non-small cell lung cancer: Impact on patient outcomes

Emily Sterbis, Rifei Liang, Premal Trivedi, Jennifer Kwak, Erica Cohen Major, Sana D Karam and Rustain Morgan
Journal of Nuclear Medicine June 2022, jnumed.122.264131; DOI: https://doi.org/10.2967/jnumed.122.264131
Emily Sterbis
1 University of Colorado, United States;
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Rifei Liang
1 University of Colorado, United States;
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Premal Trivedi
1 University of Colorado, United States;
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Jennifer Kwak
2 University of Coloardo;
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Erica Cohen Major
3 Edward Hines VA
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Sana D Karam
1 University of Colorado, United States;
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Rustain Morgan
1 University of Colorado, United States;
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Abstract

Lung cancer is the leading cause of cancer deaths within the United States, yet prior studies have shown a lack of adherence to imaging and treatment guidelines in patients with lung cancer. This paper evaluates the use of FDG PET/CT imaging prior to subsequent radiation therapy in patients with non-small cell lung cancer, as recommended by National Comprehensive Cancer Network (NCCN) guidelines, and whether the use of this imaging modality impacts cancer-specific survival. Methods: This was a retrospective study of the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program Medicare linked data in patients with non-small cell lung cancer. Hazard ratios (HRs) and 95% confidence intervals (CIs) for overall and cancer-specific survival were estimated for patients diagnosed between 2006-2015 who underwent either FDG PET/CT or CT based imaging prior to subsequent radiation therapy. Results: Significant improvement in cancer-specific survival was found in patients who had FDG PET/CT imaging prior to subsequent radiation therapy, compared to those who underwent CT (HR, 1.43; 95% CI, 1.32-1.55, P <0.0001). While the NCCN recommends FDG PET/CT prior to subsequent radiation therapy, 43.6% of patients were imaged with CT alone. Conclusion: Many patients with non-small cell lung cancer are not being imaged according to national guidelines prior to subsequent radiation, which is associated with a lower cancer specific survival.

  • Oncology: Lung
  • PET/CT
  • Other
  • PET/CT
  • guidelines
  • non-small cell lung cancer
  • radiation therapy
  • surveillance
  • Copyright © 2022 by the Society of Nuclear Medicine and Molecular Imaging, Inc.
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Journal of Nuclear Medicine: 64 (6)
Journal of Nuclear Medicine
Vol. 64, Issue 6
June 1, 2023
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Lack of adherence to guideline-based imaging prior to subsequent radiation in patients with non-small cell lung cancer: Impact on patient outcomes
Emily Sterbis, Rifei Liang, Premal Trivedi, Jennifer Kwak, Erica Cohen Major, Sana D Karam, Rustain Morgan
Journal of Nuclear Medicine Jun 2022, jnumed.122.264131; DOI: 10.2967/jnumed.122.264131

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Lack of adherence to guideline-based imaging prior to subsequent radiation in patients with non-small cell lung cancer: Impact on patient outcomes
Emily Sterbis, Rifei Liang, Premal Trivedi, Jennifer Kwak, Erica Cohen Major, Sana D Karam, Rustain Morgan
Journal of Nuclear Medicine Jun 2022, jnumed.122.264131; DOI: 10.2967/jnumed.122.264131
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Keywords

  • Oncology: Lung
  • PET/CT
  • Other
  • guidelines
  • non-small cell lung cancer
  • radiation therapy
  • surveillance
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