18F-fluoro-2-deoxy-glucose uptake predicts clinical outcome in patients with gefitinib-treated non-small cell lung cancer.
OBJECTIVE
To evaluate response and survival according to (18)F-fluoro-2-deoxy-glucose uptake at presentation in patients with gefitinib-treated non-small cell lung cancer.


METHODS
We retrospectively analyzed 84 positron emission tomography/computed tomography findings. Patient characteristics, response rates, and survivals were evaluated according to the maximum standardized uptake value (SUV) of primary tumor. The cutoff value of SUVs was obtained from receiver operating characteristic analysis.


RESULTS
The response rate (RR) was higher for never-smokers (41%) than ever-smokers (9%; P=0.001). Patients with adenocarcinoma showed higher RR than those with other tumor histopathology (35% versus 9%; P=0.009). The SUV was significantly lower in patients who were never-smokers (P=0.005), patients with adenocarcinoma (P<0.001), and female patients (P=0.017). Patients with a low SUV showed higher RR compared with those with a high SUV (53% versus 18%; P=0.003). Prolonged progression-free survival was observed in patients with low SUVs compared with those with high SUVs (median, 33.1 weeks versus 8.6 weeks; P=0.003). While controlling for performance status, smoking history, and pathology, the high SUV conferred unfavorable outcome (hazard ratio, 2.3; P=0.012). In terms of overall survival, a low SUV was associated with favorable outcome in univariate analysis (P=0.011). Patients with a low SUV showed prolonged survival in multivariate analysis (P=0.043).


CONCLUSIONS
These results suggest that low SUVs at presentation can predict favorable response and survival in gefitinib-treated non-small cell lung cancer patients.
Na
Im Il
II
Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Nowon-gu, Seoul, Korea. hmonaimil@yahoo.com
Byun
Byung Hyun
BH
Kang
Hye Jin
HJ
Cheon
Gi Jeong
GJ
Koh
Jae Soo
JS
Kim
Cheol Hyeon
CH
Choe
Du Hwan
DH
Ryoo
Baek-Yeol
BY
Lee
Jae Cheol
JC
Lim
Sang Moo
SM
Yang
Sung Hyun
SH
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000378:metabolism; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D000077156:Gefitinib; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011799:Quinazolines / Q000627:therapeutic use*; D019275:Radiopharmaceuticals / Q000378:metabolism; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D011799:Quinazolines; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D000077156:Gefitinib