Prognostic stratification using F-18 FDG PET/CT in patients with advanced stage (Stage III and IV) non-small cell lung cancer

Ys, Kim; Lee, MK; Sj, Kim; Ij, Kim; Yk, Kim; Ws, Jo; Sk, Park

doi:10.4149/neo_2010_03_241

Cited by 10 publications

(8 citation statements)

References 23 publications

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“…The prognostic value of 18 F-FDG PET is well known and has been established in other systemic treatments of breast cancer patients (31)(32)(33). The results of the present study indicate that response to 18 F-FDG PET based on SUV max significantly predicts survival in our patient population.…”

Section: Discussionsupporting

confidence: 64%

¹⁸F-FDG PET/CT Predicts Survival After Radioembolization of Hepatic Metastases from Breast Cancer

Haug

Donfack²,

Trumm³

et al. 2012

J Nucl Med

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90 Y radioembolization (selective internal radiation therapy [SIRT]) has emerged as a valuable therapeutic option in unresectable, chemotherapy-refractory hepatic metastases from breast cancer. The objective of the present study was to evaluate 18 F-FDG PET/ CT for predicting survival in these patients. Methods: Fifty-eight consecutive patients with hepatic metastases from breast cancer were treated with SIRT. Before therapy, all patients underwent MRI of the liver. 18 F-FDG PET/CT was performed at baseline and 3 mo after SIRT to calculate percentage changes in maximum 18 F-FDG standardized uptake value (SUV max ) relative to baseline. A decrease of more than 30% in the follow-up scan, compared with the baseline examination, indicated therapy response. Treatment response at 3 mo was also assessed in 43 patients using contrastenhanced MRI and CT on the basis of the Response Evaluation Criteria in Solid Tumors. All patients were followed to complete survival data. Results: Overall median survival after SIRT was 47 wk. Response as assessed with SUV max correlated significantly with survival after radioembolization, with responders having significantly longer survival (65 wk) than nonresponders (43 wk; P , 0.05). In multivariate analysis the change in SUV max was identified as the only independent predictor of survival (hazard ratio, 0.23; P , 0.005). Furthermore, a high pretherapeutic SUV max (.20) was associated with a significantly shorter median survival than was an SUV max of 20 or less (21 vs. 52 wk; P , 0.005). The presence of extrahepatic metastases (mean survival in both groups, 47 wk; P 5 0.92), hormone receptor status (estrogen, P 5 0.53; progesterone, P 5 0.79; Her-2/neu, P 5 0.49), and MRI/CT response (P 5 0.91) did not predict survival. Conclusion: The change in SUV max as assessed by 18 F-FDG PET/CT before and 3 mo after SIRT was identified as the only independent predictor of survival in patients with hepatic metastases of breast cancer. Breastcanceri s the most common malignancy affecting women in developed countries. Despite advances in adjuvant treatment, about 20% of patients with initially local disease will still develop metastases (1), frequently involving the liver. In most patients, curative surgical resection of liver metastases is not an option because of the presence of extrahepatic disease or multisegmental involvement of the liver. Other local therapies, such as radiofrequency ablation, are feasible in only a limited number of patients exhibiting only a few, small hepatic metastases. Despite significant advances in chemotherapeutic options in metastatic breast cancer, the presence of liver metastases limits survival in up to 60% of patients. Median survival in women exhibiting liver metastases of breast cancer has been estimated at about 18 mo (2).More recently, radioembolization using 90 Y-microspheres (selective internal radiation therapy [SIRT]) has emerged as a palliative treatment for hepatic metastases of various tumors (3-6). In hepatic metastases of breast cancer (7-9), reported...

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Section: Discussionsupporting

confidence: 64%

¹⁸F-FDG PET/CT Predicts Survival After Radioembolization of Hepatic Metastases from Breast Cancer

Haug

Donfack²,

Trumm³

et al. 2012

J Nucl Med

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“…The prognostic value of maximum SUV (SUVmax) at diagnosis has been evaluated in solid tumors, and these studies suggest that high SUVmax is associated with poor prognosis in esophageal cancer, head and neck cancer, and non-small cell lung cancer [8][9][10][11][12]. In addition, a small study of gastric lymphoma suggested a potential prognostic value of SUVmax on pretreatment FDG-PET [13].…”

Section: Introductionmentioning

confidence: 98%

High maximum standard uptake value (SUVmax) on PET scan is associated with shorter survival in patients with diffuse large B cell lymphoma

et al. 2011

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FDG-PET scan plays an important role in response assessment in diffuse large B cell lymphoma (DLBCL). In this study, we evaluated the prognostic value of maximum standard uptake (SUVmax) on pretreatment PET scan in DLBCL. Among 169 patients with DLBCL newly diagnosed and treated with R-CHOP between 2003 and 2008, 110 patients who had undergone pretreatment PET scan in single institute using an identical protocol were reviewed and analyzed. SUVmax at the predominant lesion on PET scan and other patient characteristics were evaluated for their association with complete response (CR) rate, overall survival (OS) and progression-free survival (PFS). The median SUVmax was 18.1 (2.0-36.4). There was no significant association between high SUV and other characteristics with the exception of PS ≥ 2 and Ki-67. Multivariate analysis revealed the independent association between high SUVmax and lower CR rate. The 3-year PFS rates in patients with SUV < 30 and those with SUV ≥ 30 were 78 and 51%, respectively (p = 0.06). The 3-year OS rates were 86 and 71%, respectively (p = 0.03). Multivariate analysis revealed that high SUVmax is a significant poor prognostic factor for both PFS and OS, independent of IPI. We showed the important prognostic value of pretreatment SUVmax of PET scan in DLBCL.

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“…The parameter used in this study for risk-stratification was a decrease in total lesion glycolysis (TLG) with a cut-off value of <50% [35]. Also, Kim et al emphasized the role of 18 F-FDG-PET/CT for prognostic stratification in 19 patients with advanced NSCLC (stage III and IV) using DeltaSUV (max) to retrospectively identify non-responders to chemotherapy [36]. The strong correlation between histological regression grading and overall survival was shown by the German Lung Cancer Cooperative Group (GLCCG), proving that patients showing regression grading IIb or III had significantly better progression free survival and overall survival [37].…”

Section: Discussionmentioning

confidence: 99%

Is <sup>18</sup>F-FDG-PET/CT a Valid Non-Invasive Predictor for Regression Grade after Neoadjuvant Treatment in Patients with NSCLC Stage III?

Klass¹,

Baüm²,

Schmuecking³

et al. 2014

JCT

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Prognostic stratification using F-18 FDG PET/CT in patients with advanced stage (Stage III and IV) non-small cell lung cancer

Abstract: 2, 12.09; p=0.0005). In conclusion, using the visual and quantitative analyses of F-18 FDG PET/CT, the responder to chemotherapy in advanced stage NSCLC patients had a better prognosis. Moreover, the potent predictor of prognosis in advanced stage NSCLC patients was %ΔSUV max .

Cited by 10 publications

References 23 publications

¹⁸F-FDG PET/CT Predicts Survival After Radioembolization of Hepatic Metastases from Breast Cancer

¹⁸F-FDG PET/CT Predicts Survival After Radioembolization of Hepatic Metastases from Breast Cancer

High maximum standard uptake value (SUVmax) on PET scan is associated with shorter survival in patients with diffuse large B cell lymphoma

Is <sup>18</sup>F-FDG-PET/CT a Valid Non-Invasive Predictor for Regression Grade after Neoadjuvant Treatment in Patients with NSCLC Stage III?

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Prognostic stratification using F-18 FDG PET/CT in patients with advanced stage (Stage III and IV) non-small cell lung cancer

Abstract: 2, 12.09; p=0.0005). In conclusion, using the visual and quantitative analyses of F-18 FDG PET/CT, the responder to chemotherapy in advanced stage NSCLC patients had a better prognosis. Moreover, the potent predictor of prognosis in advanced stage NSCLC patients was %ΔSUV max .

Cited by 10 publications

References 23 publications

18F-FDG PET/CT Predicts Survival After Radioembolization of Hepatic Metastases from Breast Cancer

18F-FDG PET/CT Predicts Survival After Radioembolization of Hepatic Metastases from Breast Cancer

High maximum standard uptake value (SUVmax) on PET scan is associated with shorter survival in patients with diffuse large B cell lymphoma

Is &lt;sup&gt;18&lt;/sup&gt;F-FDG-PET/CT a Valid Non-Invasive Predictor for Regression Grade after Neoadjuvant Treatment in Patients with NSCLC Stage III?

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¹⁸F-FDG PET/CT Predicts Survival After Radioembolization of Hepatic Metastases from Breast Cancer

¹⁸F-FDG PET/CT Predicts Survival After Radioembolization of Hepatic Metastases from Breast Cancer

Is <sup>18</sup>F-FDG-PET/CT a Valid Non-Invasive Predictor for Regression Grade after Neoadjuvant Treatment in Patients with NSCLC Stage III?