Zachary A Kohutek1, Abraham J Wu1, Zhigang Zhang2, Amanda Foster1, Shaun U Din1, Ellen D Yorke3, Robert Downey4, Kenneth E Rosenzweig5, Wolfgang A Weber6, Andreas Rimner7. 1. Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, United States. 2. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, United States. 3. Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States. 4. Department of Thoracic Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States. 5. Department of Radiation Oncology, Mount Sinai Medical Center, New York, NY, United States. 6. Department of Nuclear Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States. 7. Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, United States. Electronic address: rimnera@mskcc.org.
Abstract
OBJECTIVES: Glucose metabolic activity measured by [(18)F]-fluoro-2-deoxy-glucose positron emission tomography (FDG-PET) has shown prognostic value in multiple malignancies, but results are often confounded by the inclusion of patients with various disease stages and undergoing various therapies. This study was designed to evaluate the prognostic value of tumor FDG uptake quantified by maximum standardized uptake value (SUVmax) in a large group of early-stage non-small cell lung cancer (NSCLC) patients treated with stereotactic body radiotherapy (SBRT) using consistent treatment techniques. MATERIALS AND METHODS: Two hundred nineteen lesions in 211 patients treated with definitive SBRT for stage I NSCLC were analyzed after a median follow-up of 25.2 months. Cox regression was used to determine associations between SUVmax and overall survival (OS), disease-specific survival (DSS), and freedom from local recurrence (FFLR) or distant metastasis (FFDM). RESULTS: SUVmax >3.0 was associated with worse OS (p<0.001), FFLR (p=0.003) and FFDM (p=0.003). On multivariate analysis, OS was associated with SUVmax (HR 1.89, p=0.03), gross tumor volume (GTV) (HR 1.94, p=0.005) and Karnofsky performance status (KPS) (HR 0.51, p=0.008). DSS was associated only with SUVmax (HR 2.58, p=0.04). Both LR (HR 11.47, p=0.02) and DM (HR 3.75, p=0.006) were also associated with higher SUVmax. CONCLUSION: In a large patient population, SUVmax >3.0 was associated with worse survival and a greater propensity for local recurrence and distant metastasis after SBRT for NSCLC.
OBJECTIVES:Glucose metabolic activity measured by [(18)F]-fluoro-2-deoxy-glucose positron emission tomography (FDG-PET) has shown prognostic value in multiple malignancies, but results are often confounded by the inclusion of patients with various disease stages and undergoing various therapies. This study was designed to evaluate the prognostic value of tumorFDG uptake quantified by maximum standardized uptake value (SUVmax) in a large group of early-stage non-small cell lung cancer (NSCLC) patients treated with stereotactic body radiotherapy (SBRT) using consistent treatment techniques. MATERIALS AND METHODS: Two hundred nineteen lesions in 211 patients treated with definitive SBRT for stage I NSCLC were analyzed after a median follow-up of 25.2 months. Cox regression was used to determine associations between SUVmax and overall survival (OS), disease-specific survival (DSS), and freedom from local recurrence (FFLR) or distant metastasis (FFDM). RESULTS: SUVmax >3.0 was associated with worse OS (p<0.001), FFLR (p=0.003) and FFDM (p=0.003). On multivariate analysis, OS was associated with SUVmax (HR 1.89, p=0.03), gross tumor volume (GTV) (HR 1.94, p=0.005) and Karnofsky performance status (KPS) (HR 0.51, p=0.008). DSS was associated only with SUVmax (HR 2.58, p=0.04). Both LR (HR 11.47, p=0.02) and DM (HR 3.75, p=0.006) were also associated with higher SUVmax. CONCLUSION: In a large patient population, SUVmax >3.0 was associated with worse survival and a greater propensity for local recurrence and distant metastasis after SBRT for NSCLC.
Authors: Jonathan A Abelson; James D Murphy; Nicholas Trakul; Jose G Bazan; Peter G Maxim; Edward E Graves; Andrew Quon; Quynh-Thu Le; Maximilian Diehn; Billy W Loo Journal: Lung Cancer Date: 2012-09-23 Impact factor: 5.705
Authors: Inga S Grills; Victor S Mangona; Robert Welsh; Gary Chmielewski; Erika McInerney; Shannon Martin; Jennifer Wloch; Hong Ye; Larry L Kestin Journal: J Clin Oncol Date: 2010-01-11 Impact factor: 44.544
Authors: David B Shultz; Nicholas Trakul; Jonathan A Abelson; James D Murphy; Peter G Maxim; Quynh-Thu Le; Billy W Loo; Maximilian Diehn Journal: Clin Lung Cancer Date: 2014-01-24 Impact factor: 4.785
Authors: Zachary D Horne; David A Clump; John A Vargo; Samir Shah; Sushil Beriwal; Steven A Burton; Annette E Quinn; Matthew J Schuchert; Rodney J Landreneau; Neil A Christie; James D Luketich; Dwight E Heron Journal: Radiat Oncol Date: 2014-01-30 Impact factor: 3.481
Authors: Madison R Kocher; Anand Sharma; Elizabeth Garrett-Mayer; James G Ravenel Journal: J Comput Assist Tomogr Date: 2018 Jan/Feb Impact factor: 1.826
Authors: Jamie E Chaft; Andreas Rimner; Walter Weder; Christopher G Azzoli; Mark G Kris; Tina Cascone Journal: Nat Rev Clin Oncol Date: 2021-04-28 Impact factor: 65.011