FDG-PET parameters predict survival in non-small cell lung cancer

Quantitative PET metrics including metabolic tumor volume using F-18 FDG can project heath outcomes after chemoradiotherapy for patients with non-small cell lung cancer (NSCLC), according to a study presented Wednesday during the 2014 Annual Meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO) held Sept. 14-17 at the Moscone Center in San Francisco.

Nitin Ohri, MD, assistant professor of radiation oncology at the Albert Einstein College of Medicine in The Bronx, N.Y., presented the findings from the secondary analysis of the ECOG-ACRIN 668/RTOG 0235 clinical trial. This is a prospective, multi-center study evaluating the predictive benefit of PET for locally advanced NSCLC patients undergoing chemoradiotherapy. Results indicated that quantitative PET provided significant insights regarding local control and patient survival.

“PET metrics are strong predictors of clinical outcomes for stage III NSCLC patients treated with definitive chemoradiotherapy,” Ohri noted in his presentation.

For this study, 251 patients underwent FDG PET between 12-16 weeks following radiotherapy. The researchers assessed maximum standard uptake values (SUVmax), metabolic tumor volume and total glycolytic activity. They found that a total of 79 out of 233 patients showed local failure after pre-treatment PET at a median time of 25.3 months after registration of the study and 159 out of 214 patients, or 74 percent, died with a median survival of 20 months after study registration. Pre-treatment metabolic tumor volume was an independent marker for survival.

Post-treatment FDG PET showed that 68 out of 164 patients presented local failure and 119 out of 170 patients, or 70 percent, died. Pre-treatment metabolic tumor volume and post-treatment SUVmax were independent predictors of survival.