BACKGROUND: Many patients with stage I-III small cell lung cancer (SCLC) experience disease progression short after the completion of concurrent chemoradiotherapy (CRT). The purpose of the current study was to evaluate whether CT or FDG metabolic response early after the start of chemotherapy, but before the beginning of chest RT, is predictive for survival in SCLC. METHODS: Fifteen stage I-III SCLC patients treated with concurrent CRT with an FDG-PET and CT scan available before the start of chemotherapy and after or during the first cycle of chemotherapy, but before the start of radiotherapy, were selected. The metabolic volume (MV) was defined both within the primary tumour and in the involved nodal stations using the 40% (MV40) and 50% (MV50) threshold of the maximum SUV. Metabolic and CT response was assessed by the relative change in MV and CT volume, respectively, between both time points. The association between response and overall survival (OS) was analysed by univariate cox regression analysis. The minimum follow-up was 18 months. RESULTS: Reductions in MV40 and MV50 were -36±38% (126.4 to 68.7cm(3)) and -44±38% (90.2 to 27.8cm(3)), respectively. The median CT volume reduction was -40±64% (190.6 to 113.8cm(3)). MV40 and MV50 changes showed a significant association with survival (HR=1.02, 95% CI: 1.00-1.04 (p=0.042); HR=1.02, 95% CI: 1.00-1.04 (p=0.048), respectively), indicating a 2% increase in survival probability for 1% reduction in metabolic volume. The CT volume change was also significantly correlated with survival (HR=1.01, 95% CI: 1.00-1.03, p=0.007). CONCLUSIONS: This hypothesis generating study shows that both the early CT and the MV changes show a significant correlation with survival in SCLC. A prospective study is planned in a larger patient cohort to allow multivariate analysis, with the final aim to select patients early during treatment that could benefit from dose intensification or alternative treatment.
BACKGROUND: Many patients with stage I-III small cell lung cancer (SCLC) experience disease progression short after the completion of concurrent chemoradiotherapy (CRT). The purpose of the current study was to evaluate whether CT or FDG metabolic response early after the start of chemotherapy, but before the beginning of chest RT, is predictive for survival in SCLC. METHODS: Fifteen stage I-III SCLCpatients treated with concurrent CRT with an FDG-PET and CT scan available before the start of chemotherapy and after or during the first cycle of chemotherapy, but before the start of radiotherapy, were selected. The metabolic volume (MV) was defined both within the primary tumour and in the involved nodal stations using the 40% (MV40) and 50% (MV50) threshold of the maximum SUV. Metabolic and CT response was assessed by the relative change in MV and CT volume, respectively, between both time points. The association between response and overall survival (OS) was analysed by univariate cox regression analysis. The minimum follow-up was 18 months. RESULTS: Reductions in MV40 and MV50 were -36±38% (126.4 to 68.7cm(3)) and -44±38% (90.2 to 27.8cm(3)), respectively. The median CT volume reduction was -40±64% (190.6 to 113.8cm(3)). MV40 and MV50 changes showed a significant association with survival (HR=1.02, 95% CI: 1.00-1.04 (p=0.042); HR=1.02, 95% CI: 1.00-1.04 (p=0.048), respectively), indicating a 2% increase in survival probability for 1% reduction in metabolic volume. The CT volume change was also significantly correlated with survival (HR=1.01, 95% CI: 1.00-1.03, p=0.007). CONCLUSIONS: This hypothesis generating study shows that both the early CT and the MV changes show a significant correlation with survival in SCLC. A prospective study is planned in a larger patient cohort to allow multivariate analysis, with the final aim to select patients early during treatment that could benefit from dose intensification or alternative treatment.
Authors: J P Pignon; R Arriagada; D C Ihde; D H Johnson; M C Perry; R L Souhami; O Brodin; R A Joss; M S Kies; B Lebeau Journal: N Engl J Med Date: 1992-12-03 Impact factor: 91.245
Authors: Daniel B Fried; David E Morris; Charles Poole; Julian G Rosenman; Jan S Halle; Frank C Detterbeck; Thomas A Hensing; Mark A Socinski Journal: J Clin Oncol Date: 2004-12-01 Impact factor: 44.544
Authors: Corneline J Hoekstra; Sigrid G Stroobants; Egbert F Smit; Johan Vansteenkiste; Harm van Tinteren; Pieter E Postmus; Richard P Golding; Bonne Biesma; Frans J H M Schramel; Nico van Zandwijk; Adriaan A Lammertsma; Otto S Hoekstra Journal: J Clin Oncol Date: 2005-11-20 Impact factor: 44.544
Authors: Angela van Baardwijk; Brigitta G Baumert; Geert Bosmans; Marinus van Kroonenburgh; Sigrid Stroobants; Vincent Gregoire; Philippe Lambin; Dirk De Ruysscher Journal: Cancer Treat Rev Date: 2006-03-24 Impact factor: 12.111
Authors: I Brink; T Schumacher; M Mix; S Ruhland; E Stoelben; W Digel; M Henke; N Ghanem; E Moser; E U Nitzsche Journal: Eur J Nucl Med Mol Imaging Date: 2004-07-17 Impact factor: 9.236
Authors: Lioe-Fee de Geus-Oei; Dennis Vriens; Hanneke W M van Laarhoven; Winette T A van der Graaf; Wim J G Oyen Journal: J Nucl Med Date: 2009-05 Impact factor: 10.057
Authors: Philippe Lambin; Ruud G P M van Stiphout; Maud H W Starmans; Emmanuel Rios-Velazquez; Georgi Nalbantov; Hugo J W L Aerts; Erik Roelofs; Wouter van Elmpt; Paul C Boutros; Pierluigi Granone; Vincenzo Valentini; Adrian C Begg; Dirk De Ruysscher; Andre Dekker Journal: Nat Rev Clin Oncol Date: 2012-11-20 Impact factor: 66.675
Authors: Wouter van Elmpt; Michel Ollers; Anne-Marie C Dingemans; Philippe Lambin; Dirk De Ruysscher Journal: J Nucl Med Date: 2012-08-09 Impact factor: 10.057
Authors: Ali Salavati; Fenghai Duan; Bradley S Snyder; Bo Wei; Sina Houshmand; Benjapa Khiewvan; Adam Opanowski; Charles B Simone; Barry A Siegel; Mitchell Machtay; Abass Alavi Journal: Eur J Nucl Med Mol Imaging Date: 2017-07-08 Impact factor: 9.236
Authors: Christophe Van de Wiele; Vibeke Kruse; Peter Smeets; Mike Sathekge; Alex Maes Journal: Eur J Nucl Med Mol Imaging Date: 2012-11-14 Impact factor: 9.236