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Grambozov, B; Kalantari, F; Beheshti, M; Stana, M; Karner, J; Ruznic, E; Zellinger, B; Sedlmayer, F; Rinnerthaler, G; Zehentmayr, F.
Pretreatment 18-FDG-PET/CT parameters can serve as prognostic imaging biomarkers in recurrent NSCLC patients treated with reirradiation-chemoimmunotherapy.
Radiother Oncol. 2023; 185:109728
Doi: 10.1016/j.radonc.2023.109728
Web of Science
PubMed
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- Co-authors Med Uni Graz
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Rinnerthaler Gabriel
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- Abstract:
- BACKGROUND AND PURPOSE: Our study aimed to assess whether quantitative pretreatment 18F-FDG-PET/CT parameters could predict prognostic clinical outcome of recurrent NSCLC patients who may benefit from ablative reirradiation. MATERIALS AND METHODS: Forty-eight patients with recurrent NSCLC of all UICC stages who underwent ablative thoracic reirradiation were analyzed. Twenty-nine (60%) patients received immunotherapy with or without chemotherapy in addition to reirradiation. Twelve patients (25%) received reirradiation only and seven (15%) received chemotherapy and reirradiation. Pretreatment 18-FDG-PET/CT was mandatory in initial diagnosis and recurrence, based on which volumetric and intensity quantitative parameters were measured before reirradiation and their impact on overall survival, progression-free survival, and locoregional control was assessed. RESULTS: With a median follow-up time of 16.7 months, the median OS was 21.8 months (95%-CI: 16.2-27.3). On multivariate analysis, OS and PFS were significantly influenced by MTV (p < 0.001 for OS; p = 0.006 for PFS), TLG (p < 0.001 for OS; p = 0.001 for PFS) and SUL peak (p = 0.0024 for OS; p = 0.02 for PFS) of the tumor and MTV (p = 0.004 for OS; p < 0.001 for PFS) as well as TLG (p = 0.007 for OS; p = 0.015 for PFS) of the metastatic lymph nodes. SUL peak of the tumor (p = 0.05) and the MTV of the lymph nodes (p = 0.003) were only PET quantitative parameters that significantly impacted LRC. CONCLUSION: Pretreatment tumor and metastastic lymph node MTV, TLG and tumor SUL peak significantly correlated with clinical outcome in recurrent NSCLC patients treated with reirradiation-chemoimmunotherapy.
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Humans - administration & dosage
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Positron Emission Tomography Computed Tomography - administration & dosage
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Fluorodeoxyglucose F18 - administration & dosage
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Prognosis - administration & dosage
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Re-Irradiation - administration & dosage
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Neoplasm Recurrence, Local - diagnostic imaging, therapy
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Carcinoma, Non-Small-Cell Lung - diagnostic imaging, therapy, pathology
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Lung Neoplasms - diagnostic imaging, therapy, pathology
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Biomarkers - administration & dosage
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Retrospective Studies - administration & dosage
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Tumor Burden - administration & dosage
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Radiopharmaceuticals - administration & dosage
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Glycolysis - administration & dosage
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Recurrent non-small-cell lung cancer
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Reirradiation
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18F-FDG-PET-CT
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Metabolic tumor volume (MTV)
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Total lesion glycolysis (TLG)
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Lean body mass corrected SUV peak (SUL peak)