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Prognostic utility of serial PET/CT imaging following stereotactic body radiation therapy (SBRT) in early stage lung cancer: a single institution experience

  • Original Research
  • Published:
Journal of Radiation Oncology

Abstract

Objective

This study aimed to characterize clinical outcomes with 18F-fluorodeoxyglucose positron emission tomography (FDG-PET)/computed tomography (CT) scan results at different follow-up time points following stereotactic body radiation therapy (SBRT) for early stage non-small cell lung cancer (NSCLC).

Methods

Records of 83 patients with early stage NSCLC treated with definitive SBRT were reviewed. FDG-PET/CT scans were obtained prior to treatment, at 4 months following treatment, and serially every 6 months thereafter on all surviving patients. The FDG uptake by lesions was assessed visually as the presence or absence of focal abnormal metabolic uptake compared to pretreatment lesions and termed PET-positive or PET-negative, respectively. When available, the maximum standardized uptake value (SUVmax) was calculated to assess semiquantitative values.

Results

No correlation between PET-positive or PET-negative scan at the 4-month time interval and overall survival was observed. The 3-year overall survival for those patients with a PET-negative scan at 10 months was 60.9 % versus a 3-year overall survival of 20.8 % for patients with a PET-positive scan at that same follow-up date (P = 0.001; hazard ratio (HR) = 2.86, 95 % confidence interval (CI), 1.91–12.05).

Conclusion

FDG-PET/CT scans commonly remained positive with focal FDG uptake at 4 months following SBRT; however, this did not always indicate recurrent or residual disease. PET-negative scans at 10 months following SBRT correlated with increased overall survival.

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References

  1. Siegel R, Naishadham D, Jemal A, Ward E (2012) Cancer statistics, 2012. CA Cancer J Clin 62:10–29

    Article  PubMed  Google Scholar 

  2. Matsuo Y, Shibuya K, Nagata Y et al (2011) Prognostic factors in stereotactic body radiotherapy for non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 79:1104–1111

    Article  PubMed  Google Scholar 

  3. Onishi H, Shirato H, Nagata Y et al (2007) Hypofractionated stereotactic radiotherapy (HypoFXSRT) for stage I non-small cell lung cancer: updated results of 257 patients in a Japanese multi-institutional study. J Thorac Oncol 2:S94–S100

    Article  PubMed  Google Scholar 

  4. Videtic GM, Stephans K, Reddy C et al (2010) Intensity-modulated radiotherapy-based stereotactic body radiotherapy for medically inoperable early-stage lung cancer: excellent local control. Int J Radiat Oncol Biol Phys 77:344–349

    Article  PubMed  Google Scholar 

  5. Timmerman R, Paulus R, Galvin J et al (2010) Stereotactic body radiation therapy for inoperable early stage lung cancer. JAMA 303:1070–1076

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  6. Lo SS, Teh BS, Mayr NA et al (2012) Imaging follow-up after stereotactic ablative radiotherapy (SABR) for lung tumors. J Radiat Oncol 1:11–16

    Article  Google Scholar 

  7. Fischer-Valuck BW, Durci M, Katz SR et al (2013) Influence of patient characteristics on survival following treatment with helical stereotactic body radiotherapy (SBRT) in stage I non-small-cell lung cancer. Thorac Cancer 4:27–34

    Article  Google Scholar 

  8. Dharmarajan KV, Wexler LH, Gavane S et al (2012) Positron emission tomography (PET) evaluation after initial chemotherapy and radiation therapy predicts local control in rhabdomyosarcoma. Int J Radiat Oncol Biol Phys 84:996–1002

    Article  PubMed  Google Scholar 

  9. Clarke K, Taremi M, Dahele M et al (2012) Stereotactic body radiotherapy (SBRT) for non-small cell lung cancer (NSCLC): is FDG-PET a predictor of outcome? Radiother Oncol 104:62–66

    Article  PubMed  Google Scholar 

  10. Takeda A, Yokosuka N, Ohashi T et al (2011) The maximum standardized uptake value (SUVmax) on FDG-PET is a strong predictor of local recurrence for localized non-small-cell lung cancer after stereotactic body radiotherapy (SBRT). Radiother Oncol 101:291–297

    Article  PubMed  Google Scholar 

  11. Satoh Y, Nambu A, Onishi H et al (2012) Value of dual time point F-18 FDG-PET/CT imaging for the evaluation of prognosis and risk factors for recurrence in patients with stage I non-small cell lung cancer treated with stereotactic body radiation therapy. Eur J Radiol 81:3530–3534

    Article  PubMed  Google Scholar 

  12. Frank A, Lefkowitz D, Jaeger S et al (1995) Decision logic for retreatment of asymptomatic lung cancer recurrence based on positron emission tomography findings. Int J Radiat Oncol Biol Phys 32:1495

    Article  CAS  PubMed  Google Scholar 

  13. Bury T, Corhay J-L, Duysinx B et al (1999) Value of FDG-PET in detecting residual or recurrent nonsmall cell lung cancer. Eur Respir J 14:1376–1380

    Article  CAS  PubMed  Google Scholar 

  14. Zhang X, Liu H, Balter P et al (2012) Positron emission tomography for assessing local failure after stereotactic body radiotherapy for non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 83:1558–1565

    Article  PubMed Central  PubMed  Google Scholar 

  15. Bryant AS, Cerfolio RJ, Klemm KM et al (2006) Maximum standard uptake value of mediastinal lymph nodes on integrated FDG-PET-CT predicts pathology in patients with non-small cell lung cancer. Ann Thorac Surg 82:417–422, discussion 422–413

    Article  PubMed  Google Scholar 

  16. Matsuo Y, Nakamoto Y, Nagata Y et al (2010) Characterization of FDG-PET images after stereotactic body radiation therapy for lung cancer. Radiother Oncol 97:200–204

    Article  PubMed  Google Scholar 

Download references

Compliance with Ethics Guidelines

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Conflict of interest

Lane R. Rosen, Benjamin W. Fischer-Valuck, Michael Durci, Sanford R. Katz, Hsinshun Terry Wu, Amol Takalkar, Mansour Mirfakhraee, and David Lillian declare that they have no conflict of interest.

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Department of Radiation Oncology, Willis-Knighton Cancer Center, 2600 Kings Highway, Shreveport, LA, 71103, USA

    Lane R. Rosen, Benjamin W. Fischer-Valuck, Michael Durci, Sanford R. Katz, Hsinshun Terry Wu & Mansour Mirfakhraee

  2. Louisiana State University Health Sciences Center in Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA

    Benjamin W. Fischer-Valuck & Amol Takalkar

  3. PET Imaging Center at Biomedical Research Institute of Northern Louisiana, 1501 Kings Highway, Shreveport, LA, 71103, USA

    David Lillian

  4. Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, 63110, USA

    Benjamin W. Fischer-Valuck

Authors
  1. Lane R. Rosen
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  2. Benjamin W. Fischer-Valuck
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  3. Michael Durci
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  4. Sanford R. Katz
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  5. Hsinshun Terry Wu
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  6. Amol Takalkar
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  7. Mansour Mirfakhraee
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  8. David Lillian
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Corresponding author

Correspondence to Benjamin W. Fischer-Valuck.

Additional information

Presented in part as oral presentation at the 54th Annual Meeting of the American Society of Radiation Oncology (ASTRO) in Boston, MA, October 29, 2012 and at the Multidisciplinary Symposium in Thoracic Cancer in Chicago, IL, September 7, 2012

Lane R. Rosen and Benjamin W. Fischer-Valuck contributed equally to this manuscript.

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Rosen, L.R., Fischer-Valuck, B.W., Durci, M. et al. Prognostic utility of serial PET/CT imaging following stereotactic body radiation therapy (SBRT) in early stage lung cancer: a single institution experience. J Radiat Oncol 3, 379–386 (2014). https://doi.org/10.1007/s13566-014-0167-2

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  • DOI: https://doi.org/10.1007/s13566-014-0167-2

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