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RESEARCH PRODUCT
Stereotactic Ablative Radiation Therapy for Lung Oligometastases: Predictive Parameters of Early Response by (18)FDG-PET/CT
Rosario MazzolaRuggero RuggieriNiccolò Giaj LevraFilippo AlongiFrancesco RicchettiU. TebanoSergio FersinoStefano PasettoMatteo SalgarelloGioacchino Di PaolaAlba Fiorentinosubject
MaleFludeoxyglucose F-18Lung Neoplasmsmedicine.medical_treatment18FDG-PET/CT; Lung malignancies; Predictive factors; SABR; Adenocarcinoma; Aged; Aged 80 and over; Carcinoma Non-Small-Cell Lung; Carcinoma Squamous Cell; Female; Fluorodeoxyglucose F18; Follow-Up Studies; Humans; Lung Neoplasms; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Recurrence Local; Neoplasm Staging; Positron Emission Tomography Computed Tomography; Prognosis; Radiopharmaceuticals; Retrospective Studies; Tumor Burden; Radiosurgery; Oncology; Pulmonary and Respiratory MedicineSABR volatility model030218 nuclear medicine & medical imaging0302 clinical medicinePositron Emission Tomography Computed TomographyAblative case80 and overMedicineNon-Small-Cell LungSABRmedicine.diagnostic_test(18)FDG-PET/CTMiddle AgedPrognosisTumor Burdenmedicine.anatomical_structureLocalOncologyPositron emission tomography030220 oncology & carcinogenesisLymphatic MetastasisFemaleRadiologyPredictive factorsPulmonary and Respiratory Medicinemedicine.medical_specialtyLung malignanciesStandardized uptake value18FDG-PET/CTAdenocarcinomaRadiosurgery03 medical and health sciencesFluorodeoxyglucose F18HumansAgedNeoplasm StagingRetrospective StudiesLungbusiness.industryCarcinomaRetrospective cohort studyRadiation therapyNeoplasm RecurrenceSquamous CellRadiopharmaceuticalsbusinessNuclear medicineFollow-Up Studies(18)FDG-PET/CT; Lung malignancies; Predictive factors; SABRdescription
Abstract Objectives The objective of this study was to investigate fludeoxyglucose F 18 positron emission tomography/computed tomography ( 18 FDG-PET/CT) parameters as predictive of response after stereotactic ablative radiotherapy (SABR) for lung oligometastases. Methods The inclusion criteria of the current retrospective study were as follows: (1) lung oligometastases treated by SABR, (2) presence of 18 FDG-PET/CT before and after SABR for at least two subsequent evaluations, (3) Karnofsky performance status higher than 80, and (4) life expectancy longer than 6 months. All patients were treated with a biologically equivalent dose of at least 100 Gy with an alpha/beta ratio of 10. The following metabolic parameters were semiquantitatively defined: maximum standardized uptake value (SUV max ), mean standardized uptake value (SUV mean ), metabolic tumor volume, and total lesion glycolysis. Results A total of 50 patients met the inclusion criteria, for a total of 70 lung metastases. The pre-SABR median SUV max was 6.5 (range 4–17), the median SUV mean was 3.7 (range 2.5–6.5), and the median metabolic tumor volume was 2.3 cm 3 (0.2–31 cm 3 ). The following metabolic parameters were significantly related to complete response at 6 months: SUV max less than 5 ( p mean less than 3.5 ( p = 0.03). ΔSUV max at 3 to 6 months was +126% for lesions with in-field progression versus –26% for the remaining lesions ( p = 0.002). ΔSUV mean at 3 to 6 months was +15% for lesions with in-field progression versus –26% for the remaining metastases ( p = 0.008). Conclusions In the current analysis, complete response from lung metastasis at 6 months after stereotactic body radiation therapy was significantly associated with both the maximum and mean values of pre-SABR 18 FDG-PET/CT SUV. Longer-term trials are strongly advocated to improve the personalization of the monitoring of tumor response in patients with lung oligometastases and, consequently, monitoring of the cost-effectiveness of the health care.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2017-03-01 |