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Prognostic Value of Pre- and Posttreatment PET/CT Parameters in Patients Diagnosed with Advanced Stage NSCLC

[ Vol. 14 , Issue. 4 ]

Author(s):

Cemil Bilir*, Baran Yusufoglu, Bayram Kizilkaya and Huseyin Engin   Pages 621 - 628 ( 8 )

Abstract:


Background: PET imaging involves several parameters. However, it is not well known which parameters in each measurable site of tumors may have a greater effect on oncologic outcomes.

Method: This study included a total of 42 patients diagnosed with histology-proven NSCLC. Baseline and consecutive FDG-PET scans were carried out 3 weeks before and at least 3 months after treatment, respectively.

Results: According to the PERCIST, 9 (21%) patients had Complete Response (CR), and 3 of them underwent surgical resection. Sixteen patients (38%) had Partial Response (PR), and 4 (9.5%) had Stable Disease (SD), the remaining 15 (35%) had Progressive Disease (PD). Patients who responded to the treatment had significantly higher Overall Survival (OS) and Progression Free Survival (PFS), 15 versus 9.5 months and 10 versus 6 months, respectively. The SUVmax values decreased from 12.2 to 3.7 (P=<0.001), and the mediastinal lymph nodes SUVmax decreased from 6 to 0 (P=<0.001) in the responder group. The median TLG of the primary lesion showed a statistically significant decrease from 279 to 13.6 (P=0.0001), the median TLG of the mediastinal lymph nodes decreased from 13.2 to 0 (P= 0.04), and the median Whole Body (WB) TLG decreased from 338 to 17 (P=0.002) in the responder group. The posttreatment WB TLG was significantly correlated with OS and PFS.

Conclusion: This study showed that the posttreatment WB TLG is significantly associated with oncologic outcomes. The metabolic changes in the mediastinal lymph nodes, as shown by the SUVmax and TLG, have a prognostic value in patients who develop new metastases during treatment. Further study in a homogenous NSCLC population can help increase our understanding of the prognostic value of PET/CT parameters.

Keywords:

Lung cancer, survival, PET/CT, SUV, total lesion glycolysis, histology-proven NSCLC.

Affiliation:

Department of Medical Oncology, Sakarya University School of Medicine, Sakarya, Department of Nuclear Medicine, Teaching and Education Hospital, Recep Tayyip Erdogan University, Rize, Department of Internal Medicine, Teaching and Education Hospital, Recep Tayyip Erdogan University, Rize, Department of Medical Oncology, Bulent Ecevit University School of Medicine, Zonguldak

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