Follow-up with 18FDG-PET-CT after radical radiotherapy with or without chemotherapy allows the detection of potentially curable progressive disease in non-small cell lung cancer patients: a prospective study.
BACKGROUND
Follow-up of patients treated with curative intent for non-small cell lung cancer (NSCLC) with X-ray or CT-scans is of unproven value. Furthermore, most patients with progressive disease present with symptoms outside of follow-up visits. Because the accuracy of (18)FDG-PET-CT is superior to CT, we hypothesised that FDG-PET-CT scans 3 months post-treatment could lead to early detection of progressive disease (PD) amenable for radical treatment.


METHODS
Hundred patients with NSCLC, treated with curative intent with (chemo) radiation, were prospectively evaluated. All patients underwent a planned FDG-PET-CT scan 3 months after the start of radiotherapy.


RESULTS
Twenty four patients had PD 3 months post-treatment. 16/24 patients were symptomatic. No curative treatment could be offered to any of these patients. In 3/8 asymptomatic patients progression, potentially amenable for radical therapy was found, which were all detected with PET, not with CT only.


CONCLUSIONS
PET-scanning after curative treatment for NSCLC led to the detection of progression potentially amenable for radical treatment in a small proportion (3%) of patients. Selectively offering a PET-CT scan to the patient group without symptoms could possibly lead to an effective follow-up method.
van Loon
Judith
J
Department of Radiation Oncology (Maastro Clinic), GROW Research Institute, University Medical Centre, Dr. Tanslaan 12, NL-6229 ET Maastricht, The Netherlands. Judith.vanloon@maastro.nl
Grutters
Janneke
J
Wanders
Rinus
R
Boersma
Liesbeth
L
Oellers
Michel
M
Dingemans
Anne-Marie
AM
Bootsma
Gerben
G
Geraedts
Wiel
W
Pitz
Cordula
C
Simons
Jean
J
Fatah
Sakar Abdul
SA
Snoep
Gabriel
G
Hochstenbag
Monique
M
Lambin
Philippe
P
De Ruysscher
Dirk
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000532:radiotherapy / Q000556:secondary; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008134:Long-Term Care / Q000379:methods; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D016879:Salvage Therapy; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18