TY - JOUR T1 - Intratumoral metabolic heterogeneity can be useful to select patients for radiotherapy dose-escalation in stage III non-small cell lung cancer JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 1390 LP - 1390 VL - 56 IS - supplement 3 AU - Sae-Ryung Kang AU - Hyeon-Sik Kim AU - Ki Seong Park AU - Geum-Cheol Jeong AU - Hee Jeong Park AU - Jahae Kim AU - Jung Joon Min AU - Ho-Chun Song AU - Hee-Seung Bom AU - Seong Young Kwon Y1 - 2015/05/01 UR - http://jnm.snmjournals.org/content/56/supplement_3/1390.abstract N2 - 1390 Objectives We evaluated the value of intratumoral metabolic heterogeneity assessed using area under the curve of cumulative SUV-volume histogram (AUC-CSH) in FDG PET/CT to select patients for radiotherapy dose-escalation in patients with inoperable stage III non-small cell lung cancer (NSCLC).Methods Fifty-nine patients with inoperable stage III NSCLC, who underwent pretreatment FDG PET/CT before starting concurrent chemoradiotherapy between 2005 and 2012 were retrospectively reviewed (60 Gy: 27; 66 or 70 Gy: 32). For the classification of metabolic heterogeneity of primary tumor, median value of AUC-CSH was used. Progression-free survival (PFS), locoregional recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) curves were produced using Kaplan-Meier methods and survival difference between groups was assessed by Wilcoxon test.Results Twenty-seven patients had metabolically homogeneous primary tumors (AUC-CSH>4489) and 32 patients had heterogeneous tumors (AUC-CSH<4489). In Kaplan-Meier analysis, higher radiation dose (66 or 70 Gy) was associated with improved PFS (p=0.032), but not with LRFS (p=0.112) and DMFS (p=0.183). In metabolically homogeneous tumor group, higher radiation dose was strongly associated with improved PFS (p=0.003) and LRFS (p=0.026). However, in metabolically heterogeneous tumor group, higher radiation dose was not associated with improved PFS (p=0.952) and LRFS (p=0.949).Conclusions This preliminary study suggests that radiotherapy dose-escalation in concurrent chemoradiotherapy can improve PFS and LRFS not in the patients with metabolically heterogeneous primary lung tumor but in the patients with homogeneous tumor. ER -