Home Neoplasma 2010 Neoplasma Vol.57, No.3, p.241-246, 2010

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Neoplasma Vol.57, No.3, p.241-246, 2010

Title: Prognostic stratification using F-18 FDG PET/CT in patients with advanced stage (Stage III and IV) non-small cell lung cancer
Author: Y. S. Kim, M. K. Lee, S. J. Kim, I. J. Kim, Y. K. Kim, W. S. Jo, S. K. Park

Abstract: F-18 FDG PET could provide prognostic information in patients with advanced resectable NSCLC. In the current study, we investigated the prognostic implication of F-18 FDG PET after chemotherapy in patients with advanced stage III and IV NSCLC.
A retrospective review identified 19 patients with advanced stage (stage III and IV) NSCLC who received F-18 FDG PET/CT at diagnosis of cancer and after chemotherapy. The visual response and changes of SUV max before and after treatment on survival was investigated using Kaplan-Meier and Cox proportional hazard regression analyses.
The median follow-up time was overall 24.8 month (range, 9.4~59.8 month), for surviving patients 41 month (range, 34.1~59.8 month), and for deceased patients 16.6 month (range, 9.4~29.4 month). Overall survival after baseline F-18 FDG PET/CT at 1 year was 73.7% and at 2 year was 47.4%. Comparing patients with and without F-18 FDG PET/CT response, there was statistically significant difference in overall survival between the 2 groups (median survival time, responder, 29.4 month; non-responder, 14.2 month, Χ2=3.91, p=0.048). Also, using the %ΔSUVmax for the comparison, significant difference was existed in overall survival between 2 groups (Χ2=12.6, p=0.0004). When the tumor reveals more than 17.85% reduction of %ΔSUVmax, the survival could be predicted (AUC, 0857; standard error, 0.0866; 95% confidence interval, 0.622~0.971; sensitivity, 75%; specificity, 100%; p=0.0001). With Cox proportional hazard model, %ΔSUVmax was determined to be a potent prognostic factor for survival (Χ2, 12.09; p=0.0005).
In conclusion, using the visual and quantitative analyses of F-18 FDG PET/CT, the responder to chemotherapy in advanced stage NSCLC patients had a better prognosis. Moreover, the potent predictor of prognosis in advanced stage NSCLC patients was %ΔSUVmax.

Keywords: Non-small cell lung cancer, F-18 FDG PET/CT, survival, chemotherapy
Year: 2010, Volume: 57, Issue: 3 Page From: 241, Page To: 246
doi:10.4149/neo_2010_03_241


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