Browse > Article
http://dx.doi.org/10.7314/APJCP.2015.16.1.321

Comparison of Metabolic and Anatomic Response to Chemotherapy Based on PERCIST and RECIST in Patients with Advanced Stage Non-small Cell Lung Cancer  

Ordu, Cetin (Department of Internal Medicine, Faculty of Medicine, Bilim University)
Selcuk, Nalan A. (Department of Nuclear Medicine, Yeditepe University Hospital)
Akosman, Cengiz (Medical Oncology Section, Department of Internal Medicine, Yeditepe University Hospital)
Eren, Orhan Onder (Medical Oncology Section, Department of Internal Medicine, Yeditepe University Hospital)
Altunok, Elif C. (Department of Biostatistics, Yeditepe University Hospital)
Toklu, Turkay (Department of Nuclear Medicine, Yeditepe University Hospital)
Oyan, Basak (Medical Oncology Section, Department of Internal Medicine, Yeditepe University Hospital)
Publication Information
Asian Pacific Journal of Cancer Prevention / v.16, no.1, 2015 , pp. 321-326 More about this Journal
Abstract
Background: The aim of this study was to explore the prognostic role of metabolic response to chemotherapy, determined by FDG-PET, in patients with metastatic non-small-cell lung cancer (NSCLC). Materials and Methods: Thirty patients with metastatic NSCLC were analyzed for prognostic factors related to overall survival (OS) and progression free survival (PFS). Disease evaluation was conducted with FDG-PET/CT and contrast-enhanced CT prior to and at the end of first-line chemotherapy. Response evaluation of 19 of 30 patients was also performed after 2-3 cycles of chemotherapy. Morphological and metabolic responses were assessed according to RECIST and PERCIST, respectively. Results: The median OS and PFS were 11 months and 6.2 months, respectively. At the end of first-line chemotherapy, 10 patients achieved metabolic and anatomic responses. Of the 19 patients who had an interim response analysis after 2-3 cycles of chemotherapy, 3 achieved an anatomic response, while 9 achieved a metabolic response. In univariate analyses, favorable prognostic factors for OS were number of cycles of first-line chemotherapy, and achieving a response to chemotherapy at completion of therapy according to the PERCIST and RECIST. The OS of patients with a metabolic response after 2-3 cycles of chemotherapy was also significantly extended. Anatomic response at interim analysis did not predict OS, probably due to few patients with anatomic response. In multivariate analyses, metabolic response after completion of therapy was an independent prognostic factor for OS. Conclusions: Metabolic response is at least as effective as anatomic response in predicting survival. Metabolic response may be an earlier predictive factor for treatment response and OS in NSCLC patients.
Keywords
Advanced stage; non-small cell lung cancer; PERCIST; RECIST; FDG-PET; survival;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Dwamena BA, Sonnad SS, Angobaldo JO, et al (1999). Metastases from non-small cell lung cancer: Mediastinal staging in the 1990s-meta-analytic comparison of PET and CT. Radiology, 213, 530-36.   DOI   ScienceOn
2 Eisenhauer EA, Therasse P, Bogaerts J, et al (2009). New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer, 45, 228-47.   DOI
3 Hasbek Z, Yucel B, Salk I, et al (2014). Potential impact of atelectasis and primary tumor glycolysis on F-18 FDG PET/CT on survival in lung cancer patients. Asian Pac J Cancer Prev, 15, 4085-9.   과학기술학회마을   DOI
4 Hoekstra CJ, Stroobants SG, Smit EF, et al (2005). Prognostic relevance of response evaluation using [$^{18}F$]-2-fluoro-2-deoxy-D-glucose positron emission tomography in patients with locally advanced non-small-cell lung cancer. J Clin Oncol, 23, 8362-70.   DOI
5 Jemal A, Bray F, Center MM (2011). Global cancer statistics. CA Cancer J Clin, 61, 69-90.   DOI
6 Lee DH, Kim SK, Lee HY, et al (2009). Early prediction of response to first-line therapy using integrated $^{18}F$-FDG-PET/CT for patients with advanced/metastatic non-small cell lung cancer. Thorac Oncol, 4, 816-21.   DOI
7 Mac Manus MP, Hicks RJ, Matthews JP, et al (2003). Positron emission tomography is superior to computed tomography scanning for response-assessment after radical radiotherapy or chemoradiotherapy in patients with non-small-cell lung cancer. J Clin Oncol, 21, 1285-92.   DOI
8 Martin J, Ginsberg RJ, Venkatraman ES, et al (2002). Long-term results of combined-modality therapy in resectable nonsmall-cell lung cancer. J Clin Oncol, 20, 1989-95.   DOI
9 Miranda E, Bianchi P, Destro A, et al (2013). Genetic and epigenetic alterations in primary colorectal cancers and related lymph node and liver metastases. Cancer, 119, 266-76.   DOI
10 Nahmias C, Hanna WT, Wahl LM, et al (2007). Time course of early response to chemotherapy in non-small cell lung cancer patients with $^{18}F$-FDG PET/CT. J Nucl Med, 48, 744-51.   DOI
11 Novello S, Vavala T, Levra MG, et al (2013). Early response to chemotherapy in patients with non-small-cell lung cancer assessed by [$^{18}F$]-fluoro-deoxy-D-glucose positron emission tomography and computed tomography. Clin Lung Cancer, 14, 230-7.   DOI
12 Sekine I, Tamura T, Kunitoh H, et al (1999). Progressive disease rate as a surrogate endpoint of phase II trials fornon-smallcell lung cancer. Ann Oncol, 10, 731-3.   DOI
13 Suzuki C, Jacobsson H, Hatschek T, et al (2008). Radiologic measurements of tumor response to treatment: practical approaches and limitations. Radiographics, 28, 329-44.   DOI
14 Vansteenkiste J, Fischer BM, Dooms C, et al. (2004). Positronemission tomography in prognostic and therapeutic assessment of lung cancer: systematic review. Lancet Oncol, 5, 531-40.   DOI
15 Wahl RL, Jacene H, Kasamon Y, Lodge MA (2009). From RECIST to PERCIST: Evolving considerations for PET response criteria in solid tumors. J Nucl Med, 50, 122-50.   DOI   ScienceOn
16 Weber WA, Figlin R (2007). Monitoring cancer treatment with PET/CT: does it make a difference? J Nucl Med, 48, 36-44.
17 Weber WA, Petersen V, Schmidt B, et al (2003). Positron emission tomography in non-small-cell lung cancer: prediction of response to chemotherapy by quantitative assessment of glucose use. J Clin Oncol, 21, 2651-7.   DOI
18 Cerfolio RJ, Ojha B, Bryant AS, et al (2004). The accuracy of integrated PET-CT compared with dedicated PET alone for the staging of patients with non-small cell lung cancer. Ann Thorac Surg, 78, 1017-23.   DOI
19 Azzoli CG, Temin S, Aliff T, et al (2011). Focused update of 2009 American society of clinical oncology American society of clinical oncology clinical practice guideline update on chemotherapy for stage IV non-small-cell lung cancer. J Clin Oncol, 29, 3825-31.   DOI
20 Birchard KR, Hoang JK, Herndon JE Jr, et al (2009). Early changes in tumor size in patients treated for advanced stage non-small cell lung cancer do not correlate with survival. Cancer, 115, 581-6.   DOI
21 De Geus-Oei LF, van der Heijden HF, Visser EP, et al (2007). Chemotherapy response evaluation with 18F-FDG PET in patients with non-small cell lung cancer. Nucl Med, 48, 1592-98.   DOI
22 Ding Q, Cheng X, Yang L, et al (2014). PET/CT evaluation of response to chemotherapy in non-small cell lung cancer: PET response criteria in solid tumors (PERCIST) versus response evaluation criteria in solid tumors (RECIST). J Thorac Dis, 6, 677-83.