Relationship between PET/CT response and survival in patients with non–small-cell lung cancer treated with definitive chemoradiotherapy


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SARIHAN S., BİLGİN G. B. , SIĞIRLI D.

Uhod-Uluslararasi Hematoloji-Onkoloji Dergisi, vol.31, no.1, pp.8-18, 2021 (Peer-Reviewed Journal) identifier identifier

  • Publication Type: Article / Article
  • Volume: 31 Issue: 1
  • Publication Date: 2021
  • Doi Number: 10.4999/uhod.214343
  • Journal Name: Uhod-Uluslararasi Hematoloji-Onkoloji Dergisi
  • Journal Indexes: Science Citation Index Expanded, Scopus, Academic Search Premier, EMBASE
  • Page Numbers: pp.8-18
  • Keywords: Non-small cell lung cancer, Definitive chemo-RT, PET/CT response, Survival, POSITRON-EMISSION-TOMOGRAPHY, METABOLIC TUMOR VOLUME, FDG-PET, NEOADJUVANT CHEMOTHERAPY, CHEMORADIATION THERAPY, COMPUTED-TOMOGRAPHY, F-18-FDG PET, CONCURRENT CHEMORADIATION, PATHOLOGICAL RESPONSE, RADICAL RADIOTHERAPY

Abstract

We aimed to evaluate the relationship between PET/CT response and survival in patients with non-small cell lung cancer (NSCLC) treated with curative chemoradiotherapy. Between January and December 2012, 51 patients were treated. The median age was 61 (29-79) and the M/F ratio was 46/5. 82% of the cases were stage III and 53% were squamous cell carcinoma. Median 6300 cGy (4860-7525) radiotherapy delivered and 92% of patients received chemotherapy. A p value <0.05 was considered significant for statistical analysis. The median follow-up was 27 months (7-96 months) in November 2019. The objective response was 71% with CT at 1 month and 76% with PET/CT at 3 months. There was a significant correlation between response-1 and response-3 (p < 0.001). Tumor SUVmean3 < 2.81, SUVmax change ≥ 70% was associated with response-1 (p < 0.05). The median and 5-year overall (OS) and progression-free (PFS) survival rates were 54 months, 40% and 35 months, 38%, respectively. In Cox model, for each 1 unit increase, SUVmeanbase (HR: 1.18, 95% CI 1.01-1.38) and SUVmean3 (HR: 2.65, 95% CI 1.24-5.66) were found unfavorable factors for OS, whereas SUVmean3 (HR: 2.01, 95% CI 1.02-3.93) was also found to be a poor prognostic factor for PFS. PET/CT parameters can be used as useful markers for prognosis in patients with NSCLC undergoing curative chemoradiotherapy. It is believed that early assessment during and after treatment can be advantageous in terms of treatment modification.