Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
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Fluorodeoxyglucose positron-emission tomography ratio in non-small cell lung cancer patients treated with definitive radiotherapy

  • Kang, Hyun-Cheol (Department of Radiation Oncology, Seoul National University College of Medicine) ;
  • Wu, Hong-Gyun (Department of Radiation Oncology, Seoul National University College of Medicine) ;
  • Yu, Tosol (Department of Radiation Oncology, Seoul National University College of Medicine) ;
  • Kim, Hak Jae (Department of Radiation Oncology, Seoul National University College of Medicine) ;
  • Paeng, Jin Chul (Cancer Research Institute, Seoul National University College of Medicine)
  • Received : 2013.05.08
  • Accepted : 2013.06.15
  • Published : 2013.09.30
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Abstract

Purpose: To determine whether the maximum standardized uptake value (SUV) of [$^{18}F$] fluorodeoxyglucose uptake by positron emission tomography (FDG PET) ratio of lymph node to primary tumor (mSUVR) could be a prognostic factor for node positive non-small cell lung cancer (NSCLC) patients treated with definitive radiotherapy (RT). Materials and Methods: A total of 68 NSCLC T1-4, N1-3, M0 patients underwent FDG PET before RT. Optimal cutoff values of mSUVR were chosen based on overall survival (OS). Independent prognosticators were identified by Cox regression analysis. Results: The most significant cutoff value for mSUVR was 0.9 with respect to OS. Two-year OS was 17% for patients with mSUVR > 0.9 and 49% for those with mSUVR ${\leq}0.9$ (p = 0.01). In a multivariate analysis, including age, performance status, stage, use of chemotherapy, and mSUVR, only performance status (p = 0.05) and mSUVR > 0.9 (p = 0.05) were significant predictors of OS. Two-year OS for patients with both good performance (Eastern Cooperative Oncology Group [ECOG] ${\leq}1$) and mSUVR ${\leq}0.9$ was significantly better than that for patients with either poor performance (ECOG > 1) or mSUVR > 0.9, 23% (71% vs. 23%, p = 0.04). Conclusion: Our results suggested that the mSUVR was a strong prognostic factor among patients with lymph node positive NSCLC following RT. Addition of mSUVR to performance status identifies a subgroup at highest risk for death after RT.

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References

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