Positron-emission tomography CT to identify local recurrence in stage I lung cancer patients 1 year after stereotactic body radiation therapy

Abstract

PET/CT performed 1 year after SBRT can reliably identify local recurrence and therefore help to clarify unclear CT findings. As posttherapeutic glucose metabolism also correlates with disease-specific survival, PET/CT may help to stratify lung cancer patients for additional treatment 1 year after SBRT.

Treatment and Prognosis of Isolated Local Relapse after Stereotactic Body Radiotherapy for Clinical Stage I Non-Small-Cell Lung Cancer

“…5,6 Any improvement in salvage treatments for relapse after SBRT can contribute to more favorable survival outcomes in patients undergoing SBRT for early-stage NSCLC. 13,28,29,32 On PET, an SUVmax of greater than 5 is more likely associated with LR rather than radiation pneumonitis after SBRT, 14,28,30 and this association has been validated in another study. 9,26,27 The definition and detection of LR seem more challenging than detection of regional or distant relapse because LR is seen in previously irradiated areas.…”

Follow-Up of Patients after Stereotactic Radiation for Lung Cancer: A Primer for the Nonradiation Oncologist

“…45 Although the data is highly heterogeneous, a posttreatment SUV max ≥ 5.0, or greater than the original pretreatment SUV max appears most suggestive of recurrent disease. 32,[46][47][48] In another study with 17 local recurrences, SUV max cutoffs as low as 3.2 and 4.2 have been reported, with sensitivity and specificity of 100% and 96-98%, respectively; however, not all recurrences were pathologically proven. 49…”

Stereotactic body radiotherapy: A critical review for nonradiation oncologists

“…Although no single radiographic finding is specific for progressive disease, an enlarging area of consolidation or mass > 12 months after SBRT is cause for concern. PET is a useful tool in this setting to help discriminate tumor progression from fibrosis …”