Prognostic significance of 18 F-fluorodeoxyglucose - positron emission tomography after treatment in patients with limited stage small cell lung cancer.
OBJECTIVE
Small cell lung cancer (SCLC) represents 15% to 25% of lung cancers. Despite favorable initial treatment response rates, recurrence is likely and long-term prognosis dismal. Accurate measurement of therapy response is critical to determine which patients might be spared additional treatment, and potential side effects. (18)F-fluorodeoxyglucose positron emission tomography (PET) may help distinguish necrotic or fibrous tissue from residual cancer, thus informing further treatment and prognosis. DESIGN/SETTING/PARTICIPANTS AND METHODS: Retrospective chart review study of limited stage SCLC patients with PET scanning within 4 months post-chemotherapy at Marshfield Clinic, Marshfield, Wisconsin. Diagnosis of SCLC occurred from December 1, 2001 through December 31, 2007.


RESULTS
Twenty-two patients (approximately 7%) had post-treatment PET: 11 positive, 11 negative. Median duration from last chemotherapy to PET was 36 days (range, 3 to 125 days). Median follow-up for all patients was 34.4 months (range, 6.8 to 65.9 months). Estimated median progression-free survival for all patients was 8.1 months (95% confidence intervals [CI], 4.3 to 11.9 months), 10.5 months for PET negative (95% CI, 8.1 to >57.8 months) and 4.3 months for PET positive patients (95% CI, 2.8 to >7.2 months) (P<0.007, log-rank test). Median survival for all patients was 19.2 months (95% CI, 10.3 to >65.8 months). Estimated median survival for PET negative patients was longer than PET positive (29.2 versus 10.3 months, P=0.10).


CONCLUSIONS
Post-treatment PET, prognostically significant, may be underutilized.
Onitilo
Adedayo A
AA
Department of Hematology/Oncology, Marshfield Clinic - Weston Center, 3501 Cranberry Boulevard, Weston, Wisconsin 54476, USA. onitilo.adedayo@marshfieldclinic.org
Engel
Jessica M
JM
Demos
Jennifer M
JM
Mukesh
Bickol
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018288:Carcinoma, Small Cell / Q000000981:diagnostic imaging* / Q000628:therapy*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies
D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
Lung Cancer. 2002 Sep;37(3):271-6
12234695
Lung Cancer. 2002 Jul;37(1):1-6
12057859
Semin Nucl Med. 2002 Oct;32(4):272-5
12524651
J Clin Oncol. 2004 Jan 1;22(1):127-32
14701775
Radiology. 2004 May;231(2):305-32
15044750
Ann Intern Med. 1985 Sep;103(3):430-8
2992337
Cancer. 1985 Oct 15;56(8):2107-11
2992757
J Clin Oncol. 1989 Mar;7(3):344-54
2537384
Chest. 1991 Jun;99(6):1425-32
2036826
J Clin Oncol. 1995 May;13(5):1215-20
7738624
Cancer. 2005 Dec 15;104(12):2650-7
16284984
Lung Cancer. 2006 Oct;54(1):41-9
16919841
J Nucl Med. 2007 Jan;48 Suppl 1:28S-35S
17204718
Am J Clin Oncol. 2007 Feb;30(1):45-50
17278894
Eur J Nucl Med. 2001 Apr;28(4):483-8
11357499
Eur J Nucl Med Mol Imaging. 2003 Jan;30(1):78-84
12483413