Skip to main content

Advertisement

SpringerLink
Log in

Watch the weathercock: changes in re-staging 18F-FDG PET/CT scan predict the probability of relapse in locally advanced non-small cell lung cancer

  • Brief Research Article
  • Published:
Clinical and Translational Oncology Aims and scope Submit manuscript

Abstract

Introduction

Induction treatment is be coming the gold standard for locally advanced non-small cell lung cancers (LA-NSCLC). In contrast to baseline positron emission/computed tomography scan (PET/CT scan), re-staging PET/CT scan has been poorly studied in LA-NSCLC.

Materials and methods

We retrospectively explored the efficacy of re-staging PET/CT scan to diagnose response and to predict disease-free survival (DFS) in 55 induction-treated LA-NSCLC further treated with curative surgery or radiation but not with adjuvant therapy.

Results

Re-staging N status by PET/CT scan significantly correlated with pathological N status. Radiological or metabolic response in the re-staging PET/CT scan was associated with a significantly better DFS, which decreased from 25.8 to 19.3, to 11.2, and to 9.4 months in cN0, cN1, cN2, and cN3 patients, respectively.

Conclusion

Re-staging PET/CT scan helps to define response and consolidation treatment in induction-treated LA-NSCLC and predicts DFS. Further extended studies should confirm our results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Vallières E, Shepherd FA, Crowley J, Van Houtte P, Postmus PE, Carney D, et al. The IASLC lung cancer staging project: proposals regarding the relevance of TNM in the pathologic staging of small cell lung cancer in the forthcoming (seventh) edition of the TNM classification for lung cancer. J Thorac Oncol. 2011;4:1049–59.

    Article  Google Scholar 

  2. Felip E, Rosell R, Maestre JA, Rodríguez-Paniagua JM, Morán T, Astudillo J, et al. Preoperative chemotherapy plus surgery versus surgery plus adjuvant chemotherapy versus surgery alone in early-stage non-small-cell lung cancer. J Clin Oncol. 2010;28:3138–45.

    Article  CAS  PubMed  Google Scholar 

  3. Mouillet G, Monnet E, Milleron B, Puyraveau M, Quoix E, David P, et al. Pathologic complete response to preoperative chemotherapy predicts cure in early-stage non-small-cell lung cancer: combined analysis of two IFCT randomized trials. J Thorac Oncol. 2012;7:84184–9.

    Article  Google Scholar 

  4. Rami-Porta R, Crowley JJ, Goldstraw P. The revised TNM staging system for lung cancer. Ann Thorac Cardiovasc Surg. 2009;15:4–9.

    PubMed  Google Scholar 

  5. Amini A, Correa AM, Komaki R, Chang JY, Tsao AS, Roth JA, et al. The role of consolidation therapy for stage III non-small cell lung cancer with persistent N2 Disease after induction chemotherapy. Ann Thorac Surg. 2012;94:914–20.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Higgins KA, Chino JP, Ready N, Onaitis MW, Berry MF, D’Amico TA, et al. Persistent N2 disease after neoadjuvant chemotherapy for non-small-cell lung cancer. J Thorac Cardiovasc Surg. 2011;142:1175–9.

    Article  PubMed  Google Scholar 

  7. Everitt SJ, Ball DL, Hicks RJ, Callahan J, Plumridge N, Collins M, et al. Differential 18F-FDG and 18F-FLT uptake on serial PET/CT imaging before and during definitive chemoradiation for non-small cell lung cancer. J Nucl Med. 2014;55:1069–74.

    Article  CAS  PubMed  Google Scholar 

  8. Marquez-Medina D, Martin-Marco A, Ojanguren-Garranz A. Age does not worsen the efficacy nor tolerance to combined induction therapies in locally advanced non-small cell lung cancer. Anticancer Res. 2014;34:4373–6.

    PubMed  Google Scholar 

  9. Ding Q, Cheng X, Yang L, Zhang Q, Chen J, Li T, et al. 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. 2014;6:677–83.

    PubMed Central  PubMed  Google Scholar 

  10. Flechsig P, Kratochwil C, Schwartz LH, Rath D, Moltz J, Antoch G, et al. Quantitative volumetric CT-histogram analysis in N-staging of 18F-FDG-equivocal patients with lung cancer. J Nucl Med. 2014;55:559–64.

    Article  CAS  PubMed  Google Scholar 

  11. Taus Á, Aguiló R, Curull V, Suárez-Piñera M, Rodríguez-Fuster A, Rodríguez de Dios N, et al. Impact of 18F-FDG PET/CT in the treatment of patients with non-small cell lung cancer. Arch Bronconeumol. 2014;50:99–104.

    Article  PubMed  Google Scholar 

  12. Nair VJ, MacRae R, Sirisegaram A, Pantarotto JR. Pretreatment [(18)F]-fluoro-2-deoxy-glucose positron emission tomography maximum standardized uptake value as predictor of distant metastasis in early-stage non-small cell lung cancer treated with definitive radiation therapy: rethinking the role of positron emission tomography in personalizing treatment based on risk status. Int J Radiat Oncol Biol Phys. 2014;88:312–8.

    Article  PubMed  Google Scholar 

  13. Takeda A, Sanuki N, Fujii H, Yokosuka N, Nishimura S, Aoki Y, et al. Maximum standardized uptake value on FDG-PET is a strong predictor of overall and disease-free survival for non-small-cell lung cancer patients after stereotactic body radiotherapy. J Thorac Oncol. 2014;9:65–73.

    Article  PubMed  Google Scholar 

  14. Ulger S, Demirci NY, Eroglu FN, Cengiz HH, Tunc M, Tatci E, et al. High FDG uptake predicts poorer survival in locally advanced nonsmall cell lung cancer patients undergoing curative radiotherapy, independently of tumor size. J Cancer Res Clin Oncol. 2014;140:495–502.

    Article  CAS  PubMed  Google Scholar 

  15. Muto J, Hida Y, Kaga K, Ohtaka K, Okamoto S, Tamaki N, et al. Use of maximum standardized uptake value on fluorodeoxyglucose positron-emission tomography in predicting lymph node involvement in patients with primary non-small cell lung cancer. Anticancer Res. 2014;34:805–10.

    PubMed  Google Scholar 

  16. Farjah F, Lou F, Sima C, Rusch VW, Rizk NP. A prediction model for pathologic N2 disease in lung cancer patients with a negative mediastinum by positron emission tomography. J Thorac Oncol. 2013;8:1170–80.

    Article  CAS  PubMed  Google Scholar 

  17. Trister AD, Pryma DA, Xanthopoulos E, Kucharczuk J, Sterman D, Rengan R. prognostic value of primary tumor FDG uptake for occult mediastinal lymph node involvement in clinically N2/N3 node-negative non-small cell lung cancer. Am J Clin Oncol. 2014;37:135–9.

    Article  CAS  PubMed  Google Scholar 

  18. Zeliadt SB, Loggers ET, Slatore CG, Au DH, Hebert PL, Klein GJ, et al. Preoperative PET and the reduction of unnecessary surgery among newly diagnosed lung cancer patients in a community setting. J Nucl Med. 2014;55:379–85.

    Article  PubMed  Google Scholar 

  19. Cook GJ, Yip C, Siddique M, Goh V, Chicklore S, Roy A, et al. Are pretreatment 18F-FDG PET tumor textural features in non-small cell lung cancer associated with response and survival after chemoradiotherapy? J Nucl Med. 2013;54:19–26.

    Article  PubMed  Google Scholar 

  20. Machtay M, Duan F, Siegel BA, Snyder BS, Gorelick JJ, Reddin JS, et al. Prediction of survival by [18F] fluorodeoxyglucose positron emission tomography in patients with locally advanced non-small-cell lung cancer undergoing definitive chemoradiation therapy: results of the ACRIN 6668/RTOG 0235 trial. J Clin Oncol. 2013;31:3823–30.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Xu X, Yu J, Sun X, Yang G, Li K, Fu Z, et al. The prognostic value of 18F-fluorodeoxyglucose uptake by using serial positron emission tomography and computed tomography in patients with stage III nonsmall cell lung cancer. Am J Clin Oncol. 2008;31:470–5.

    Article  PubMed  Google Scholar 

  22. Bollineni VR, Widder J, Pruim J, Langendijk JA, Wiegman EM. Residual (18)F-FDG-PET uptake 12 Weeks after stereotactic ablative radiotherapy for stage I non-small-cell lung cancer predicts local control. Int J Radiat Oncol Biol Phys. 2012;83:e551–5.

    Article  CAS  PubMed  Google Scholar 

  23. Lopez Guerra JL, Gladish G, Komaki R, Gomez D, Zhuang Y, Liao Z. Large decreases in standardized uptake values after definitive radiation are associated with better survival of patients with locally advanced non-small cell lung cancer. J Nucl Med. 2012;53:225–33.

    Article  PubMed  Google Scholar 

  24. Na F, Wang J, Li C, Deng L, Xue J, Lu Y. Primary tumor standardized uptake value measured on F18-fluorodeoxyglucose positron emission tomography is of prediction value for survival and local control in non-small-cell lung cancer receiving radiotherapy: meta-analysis. J Thorac Oncol. 2014;9:834–42.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  25. Usmanij EA, de Geus-Oei LF, Troost EG, Peters-Bax L, van der Heijden EH, Kaanders JH, et al. 18F-FDG PET early response evaluation of locally advanced non-small cell lung cancer treated with concomitant chemoradiotherapy. J Nucl Med. 2013;54:1528–34.

    Article  CAS  PubMed  Google Scholar 

  26. Lin MY, Wu M, Brennan S, Campeau MP, Binns DS, MacManus M, et al. Absence of a relationship between tumor 18F-fluorodeoxyglucose standardized uptake value and survival in patients treated with definitive radiotherapy for non-small-cell lung cancer. J Thorac Oncol. 2014;9:377–82.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  27. Win T, Miles KA, Janes SM, Ganeshan B, Shastry M, Endozo R, et al. Tumor heterogeneity as measured on the CT component of PET/CT predicts survival in patients with potentially curable non-small cell lung cancer. Clin Cancer Res. 2013;19:3591–9.

    Article  CAS  PubMed  Google Scholar 

  28. Davison J, Mercier G, Russo G, Subramaniam RM. PET-based primary tumor volumetric parameters and survival of patients with non-small cell lung carcinoma. AJR Am J Roentgenol. 2013;200:635–40.

    Article  PubMed  Google Scholar 

  29. De Cabanyes Candela S, Detterbeck FC. A systematic review of restaging after induction therapy for stage IIIa lung cancer: prediction of pathologic stage. J Thorac Oncol. 2010;5:389–98.

    Article  PubMed  Google Scholar 

  30. Cerfolio RJ, Bryant AS, Minnich DJ. Complete thoracic mediastinal lymphadenectomy leads to a higher rate of pathologically proven N2 disease in patients with non-small cell lung cancer. Ann Thorac Surg. 2012;94:902–6.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

Authors thank patients and relatives, whose trust and affection motivate us to improve, and coworkers from our centers, Vall d’Hebron, and Bellvitge Hospitals, whose collaboration helped us to obtain these results. The collaboration of DM with the Royal Marsden Hospital is supported by the Spanish Society of Medical Oncology. SP acknowledges NHS funding to the Royal Marsden Hospital/Institute of Cancer Research NIHR Biomedical Research Centre.

Author information

Authors and Affiliations

  1. Medical Oncology Department, Arnau de Vilanova University Hospital of Lleida, Avda. Rovira Roure, 80, 25198, Lleida, Spain

    D. Marquez-Medina & A. Martin-Marco

  2. Lung Unit, Royal Marsden Hospital, London, UK

    S. Popat

Authors
  1. D. Marquez-Medina
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Martin-Marco
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. Popat
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D. Marquez-Medina.

Ethics declarations

Conflict of interest

Authors do not declare any conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Marquez-Medina, D., Martin-Marco, A. & Popat, S. Watch the weathercock: changes in re-staging 18F-FDG PET/CT scan predict the probability of relapse in locally advanced non-small cell lung cancer. Clin Transl Oncol 18, 228–232 (2016). https://doi.org/10.1007/s12094-015-1349-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12094-015-1349-0

Keywords

Search

Navigation