title: Complete metabolic tumour response, assessed by 18-fluorodeoxyglucose positron emission tomography (18FDG-PET), after induction chemotherapy predicts a favourable outcome in patients with locally advanced non-small cell lung cancer (NSCLC).
abstract: BACKGROUND
  18FDG-PET and multislice computerized axial tomography (CT) scan are used for diagnosis, staging and response evaluation in NSCLC patients. The correlation between the response assessment by both imaging techniques and survival was assessed in patients with unresectable stage III NSCLC treated with induction chemotherapy followed by consolidation radiotherapy.
  
  
  METHODS
  Thirty-one patients, enrolled in a phase II study evaluating the efficacy and toxicity of a novel triplet induction chemotherapy (paclitaxel, carboplatin and gemcitabine) (PACCAGE) before consolidation radiotherapy, were evaluated by CT and 18FDG-PET at baseline and after three cycles of chemotherapy. The correlation between CT and 18FDG-PET response and time to progression and overall survival was analyzed using the Kaplan-Meier estimates of survival and the log rank test.
  
  
  RESULTS
  Ten patients with a complete response (CR) on 18FDG-PET had a significantly longer time to progression and overall survival than patients with a non-CR (median 19.9 months versus 9.8 months, p=0.026, and median >49 months versus 14.4 months, p=0.004, respectively). Twenty patients with a partial CT response (PR) had a significantly longer time to progression (median 15 months versus 9.4 months, p=0.001) than patients with a non-PR but the difference in overall survival only showed a trend (23.3 months versus 14.4 months, p=0.093).
  
  
  CONCLUSIONS
  A CR on 18FDG-PET following induction chemotherapy for locally advanced, unresectable NSCLC seems to be a more powerful prognostic marker for survival compared to PR on CT.
authors.affiliation: Department of Medical Oncology, Oncologisch Centrum, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090 Jette, Belgium.
authors.forename: L
authors.initials: L
authors.lastname: Decoster
authors.forename: D
authors.initials: D
authors.lastname: Schallier
authors.forename: H
authors.initials: H
authors.lastname: Everaert
authors.forename: K
authors.initials: K
authors.lastname: Nieboer
authors.forename: M
authors.initials: M
authors.lastname: Meysman
authors.forename: B
authors.initials: B
authors.lastname: Neyns
authors.forename: J
authors.initials: J
authors.lastname: De Mey
authors.forename: J
authors.initials: J
authors.lastname: De Grève
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016190:Carboplatin / Q000008:administration & dosage; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals; D011878:Radiotherapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D019275:Radiopharmaceuticals; D003841:Deoxycytidine; D019788:Fluorodeoxyglucose F18; D016190:Carboplatin; D017239:Paclitaxel; D000093542:Gemcitabine