title: Predicting chemotherapy response to paclitaxel-based therapy in advanced non-small-cell lung cancer (stage IIIb or IV) with a higher T stage (> T2). Technetium-99m methoxyisobutylisonitrile chest single photon emission computed tomography and P-glycoprotein express ion.
abstract: OBJECTIVE
  The aim of this study was to compare technetium-99m methoxyisobutylisonitrile (Tc-MIBI) chest single photon emission computed tomography (SPECT) results, immunohistochemical analyses of P-glycoprotein (Pgp) expression and response to paclitaxel in non-small-cell lung cancer (NSCLC).
  
  
  METHODS
  Before chemotherapy with paclitaxel, 30 patients with stage IIIb or IV NSCLC were enrolled in this study. Early chest SPECT was performed 10 min after intravenous injection of Tc-MIBI. Tc-MIBI chest SPECT images were qualitatively interpreted. Early tumor-to-normal lung ratios (T/NL) were calculated quantitatively. Immunohistochemical analyses were performed on multiple nonconsecutive sections of the biopsy specimens to determine Pgp expression. Chemotherapy response was evaluated in the third month after completion of treatment by clinical and radiological methods.
  
  
  RESULTS
  All 15 (100%) cases with good response and negative Pgp expression had positive results of early Tc-MIBI chest SPECT. Ten of 15 (67%) cases with poor response and positive Pgp expression had negative results of early Tc-MIBI chest SPECT. These early T/NL ratios (3.3 +/- 0.8 for the 15 patients with good response and 2.0 +/- 0.2 for the 5 patients with poor response) in lung cancer could be detected on early Tc-MIBI chest SPECT. The difference was significant (p < 0.05) by an independent Student t test. However, no significant differences were found for other prognostic factors (age, sex, body weight loss, performance status, tumor cell type, and tumor stage) between the good and poor response groups.
  
  
  CONCLUSIONS
  Early Tc-MIBI chest SPECT can be used to understand the Pgp expression in NSCLC and to quickly predict chemotherapy response to paclitaxel.
authors.affiliation: Division of Pulmonary/Critical Care Medicine, Department of Medicine, China Medical College Hospital, Taichung, Taiwan.
authors.forename: Wu-Huei
authors.initials: WH
authors.lastname: Hsu
authors.forename: Ruoh-Fang
authors.initials: RF
authors.lastname: Yen
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
authors.forename: Shih-Chih
authors.initials: SC
authors.lastname: Shiun
authors.forename: Nan-Yung
authors.initials: NY
authors.lastname: Hsu
authors.forename: Cheng-Chieh
authors.initials: CC
authors.lastname: Lin
authors.forename: Cheng-Chun
authors.initials: CC
authors.lastname: Lee
mesh_terms: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000235:genetics / Q000378:metabolism; D000328:Adult; D000368:Aged; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000627:therapeutic use*; D008517:Phytotherapy; D011237:Predictive Value of Tests; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome
chemical_list: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D000972:Antineoplastic Agents, Phytogenic; D017256:Technetium Tc 99m Sestamibi; D017239:Paclitaxel