BACKGROUND AND PURPOSE: Distant metastases are the dominant mode of failure after stereotactic body radiotherapy (SBRT) for early-stage non-small cell lung cancer (NSCLC). The primary study objective was to evaluate if the maximum standardized uptake value (SUV(max)) on pre-treatment FDG-PET/CT predicted clinical outcomes. Secondary objectives were to correlate 3-month post-SBRT SUV(max) and change in SUV(max) with outcomes. MATERIALS AND METHODS: Consecutive patients with medically inoperable early-stage NSCLC and an FDG-PET/CT scan before (n=82) and 3 months after (n=62) SBRT. RESULTS: Median follow up was 2 years. On univariate analysis baseline SUV(max) predicted for distant failure (p=0.0096), relapse free survival (RFS) (p=0.037) and local failure (p=0.044). On multivariate analysis baseline SUV(max) predicted for RFS (p=0.037). Baseline SUV(max) of above 5 was the most statistically significant cut off point for predicting distant failure (p=0.0002). Baseline SUV(max) ≥4.75 (median) was correlated with a higher risk of distant failure (p=0.012) and poorer RFS (p=0.04). Patients with a post-SBRT SUV(max) ≥2 and a reduction of <2.55 had a significantly higher rate of distant failure. CONCLUSIONS: Pre-SBRT SUV(max) on FDG-PET/CT correlated most strongly with distant failure. A cut off of ≥5 was the most significant. Post-SBRT SUV(max) ≥2 and a reduction of <2.55 were associated with a higher risk of distant failure.
BACKGROUND AND PURPOSE: Distant metastases are the dominant mode of failure after stereotactic body radiotherapy (SBRT) for early-stage non-small cell lung cancer (NSCLC). The primary study objective was to evaluate if the maximum standardized uptake value (SUV(max)) on pre-treatment FDG-PET/CT predicted clinical outcomes. Secondary objectives were to correlate 3-month post-SBRT SUV(max) and change in SUV(max) with outcomes. MATERIALS AND METHODS: Consecutive patients with medically inoperable early-stage NSCLC and an FDG-PET/CT scan before (n=82) and 3 months after (n=62) SBRT. RESULTS: Median follow up was 2 years. On univariate analysis baseline SUV(max) predicted for distant failure (p=0.0096), relapse free survival (RFS) (p=0.037) and local failure (p=0.044). On multivariate analysis baseline SUV(max) predicted for RFS (p=0.037). Baseline SUV(max) of above 5 was the most statistically significant cut off point for predicting distant failure (p=0.0002). Baseline SUV(max) ≥4.75 (median) was correlated with a higher risk of distant failure (p=0.012) and poorer RFS (p=0.04). Patients with a post-SBRT SUV(max) ≥2 and a reduction of <2.55 had a significantly higher rate of distant failure. CONCLUSIONS: Pre-SBRT SUV(max) on FDG-PET/CT correlated most strongly with distant failure. A cut off of ≥5 was the most significant. Post-SBRT SUV(max) ≥2 and a reduction of <2.55 were associated with a higher risk of distant failure.
Authors: Shulong Li; Ning Yang; Bin Li; Zhiguo Zhou; Hongxia Hao; Michael R Folkert; Puneeth Iyengar; Kenneth Westover; Hak Choy; Robert Timmerman; Steve Jiang; Jing Wang Journal: Med Image Anal Date: 2018-09-15 Impact factor: 8.545
Authors: Feng Liu; An Tai; Percy Lee; Tithi Biswas; George X Ding; Isaam El Naqa; Jimm Grimm; Andrew Jackson; Feng-Ming Spring Kong; Tamara LaCouture; Billy Loo; Moyed Miften; Timothy Solberg; X Allen Li Journal: Radiother Oncol Date: 2016-11-18 Impact factor: 6.280
Authors: Zhiguo Zhou; Michael Folkert; Puneeth Iyengar; Kenneth Westover; Yuanyuan Zhang; Hak Choy; Robert Timmerman; Steve Jiang; Jing Wang Journal: Phys Med Biol Date: 2017-05-08 Impact factor: 3.609
Authors: Zachary A Kohutek; Abraham J Wu; Zhigang Zhang; Amanda Foster; Shaun U Din; Ellen D Yorke; Robert Downey; Kenneth E Rosenzweig; Wolfgang A Weber; Andreas Rimner Journal: Lung Cancer Date: 2015-05-28 Impact factor: 5.705