RT Journal Article
SR Electronic
T1 Prognostic Value of FDG PET Metabolic Parameters Before and After 42 Gy of Radiochemotherapy in Patients with Inoperable Stage III Nonsmall Cell Lung Cancer
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 516
OP 524
DO 10.2967/jnumed.124.268499
VO 66
IS 4
A1 Vera, Pierre
A1 Giraud, Philippe
A1 Hapdey, Sébastien
A1 Gouel, Pierrick
A1 Jan, Orianne
A1 Le Roux, Paul
A1 Langlais, Alexandra
A1 Lévêque, Emilie
A1 Le Tinier, Florence
A1 Olivier, Anaïs
A1 Martin, Etienne
A1 Berriolo-Riedinger, Alina
A1 Pourel, Nicolas
A1 Broglia, Jean Marc
A1 Boisselier, Pierre
A1 Guillemard, Sophie
A1 Salem, Naji
A1 Brenot-Rossi, Isabelle
A1 Garcia, Camilo
A1 Berthold, Céline
A1 Giroux-Leprieur, Etienne
A1 Moreau, Damien
A1 Guillerm, Sophie
A1 Benali, Khadija
A1 Tessonnier, Laurent
A1 Audigier-Valette, Clarisse
A1 Lerouge, Delphine
A1 Quak, Elske
A1 Massabeau, Carole
A1 Courbon, Frédéric
A1 Loo, Maxime
A1 Larrouy, Anne
A1 Ghazzar, Nadia
A1 Chaumet-Riffaud, Philippe
A1 Amour, Elodie
A1 Zalcman, Gérard
A1 Modzelewski, Romain
A1 Thureau, Sébastien
YR 2025
UL http://jnm.snmjournals.org/content/66/4/516.abstract
AB The purpose of this study was to assess the prognostic value of 18F-FDG PET parameter variation between baseline and 42 Gy (PET2) of radiochemotherapy at 6 mo and 1 y of evaluation in patients with stage III inoperable nonsmall cell lung cancer based on RECIST 1.1. Methods: In total, 158 patients in a prospective multicenter phase II/III study were analyzed. Patients were randomized into 2 groups: an experimental arm (group A) and a standard arm (group B). Patients from group A with residual metabolism on PET2 (group A+) at 42 Gy received a radiation boost (74 Gy). Patients without residual uptake on 18F-FDG PET at 42 Gy (group A−) and patients in group B received a standard radiotherapy dose (66 Gy). We compared group A with group B. The 18F-FDG PET parameters SUVmax, SUVmean, SUVpeak, peak SUV normalized on lean body mass, mean SUV normalized on lean body mass, total lesion glycolysis, total metabolic tumor volume (MTV) (tumor and nodes), and tumor MTV were measured. All patients were evaluated with RECIST 1.1 using CT at 6 mo and 1 y after radiochemotherapy. Progression-free survival and overall survival were evaluated. Results: Except for the radiotherapy dose (P < 0.001), patient demographic characteristics were similar between the 2 groups (A vs. B). All 18F-FDG PET uptake and volume parameter measurements were correlated. Therefore, only the change in SUVmax (ΔSUVmax) and total MTV were selected for the analysis. There was no significant difference in any variable between the 2 groups. In the multivariate analysis, ΔSUVmax appeared to be the most important prognostic factor for overall survival, and SUVmax of PET2 appeared to be the most important prognostic factor for progression-free survival. Conclusion: 18F-FDG PET at 42 Gy can be used to identify good responders to radiochemotherapy in patients with inoperable stage III nonsmall cell lung cancer. The SUVmax of PET2 and ΔSUVmax are independent prognostic factors.