title: Metabolic activity on [18f]-fluorodeoxyglucose-positron emission tomography/computed tomography and glucose transporter-1 expression might predict clinical outcomes in patients with limited disease small-cell lung cancer who receive concurrent chemoradiation.
abstract: BACKGROUND
  Limited disease small-cell lung cancer responds well to concurrent chemoradiation therapy (CCRT), but shows high relapse rate and short RFS. We aimed to evaluate tumor metabolic activities measured using FDG-PET as a prognostic factor and analyze its relationships with markers of tumor biologic behavior.
  
  
  METHODS
  Forty-one LD-SCLC patients receiving 4 cycles of EP (etoposide 120 mg/m(2), days 1-3; cisplatin 60 mg/m(2), day 1), 2 cycles of EP (etoposide 130 mg/m(2), days 1-3; cisplatin 30 mg/m(2), day 1)-CCRT were enrolled. Maximum standardized uptake value (SUV; SUVmax) of primary tumor was revised with SUV of liver (SUVlivermax). Differences between pre-, posttreatment average SUV uptake of primary tumor, and intrathoracic lymph nodes were presented as ΔSUVliveravg. Thirty-one tumor biopsy specimens were immunostained for GLUT-1, Bcl-2, and HIF-1α.
  
  
  RESULTS
  The median overall survival (OS), and RFS were 13.7 and 10.4 months, respectively. In multivariate analysis, pretreatment lactate dehydrogenase (LDH) and ΔSUVliveravg correlated with RFS (hazard ratio [HR], 2.8, P = .043; HR, 0.3, P = .004). Sex, LDH, objective tumor metabolic response, and SUVlivermax correlated with OS (HR, 12.1, P = .006; HR, 3.7, P = .037; HR, 10.1, P = .008; and HR, 0.2, P = .014, respectively). High GLUT-1 positivity (> 75%), and LDH level (> 400 U/L) correlated with better objective response rate (P = .012) and HIF-1α immunoreactivity score (P = .029).
  
  
  CONCLUSIONS
  ΔSUVliveravg and GLUT-1 expression might predict RFS and ORR in patients with LD-SCLC treated with definitive CCRT.
authors.affiliation: Department of Internal Medicine, Lung Cancer Multidisciplinary Team, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors.forename: Jieun
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Lung Cancer Multidisciplinary Team, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors.forename: Jung Oh
authors.initials: JO
authors.lastname: Kim
authors.affiliation: Department of Hospital Pathology, Lung Cancer Multidisciplinary Team, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors.forename: Chan Kwon
authors.initials: CK
authors.lastname: Jung
authors.affiliation: Department of Radiation Oncology, Lung Cancer Multidisciplinary Team, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors.forename: Yeon Shil
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Nuclear Medicine, Lung Cancer Multidisciplinary Team, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors.forename: Ie Ryung
authors.initials: IeR
authors.lastname: Yoo
authors.affiliation: Department of Nuclear Medicine, Lung Cancer Multidisciplinary Team, St. Vincent's Hospital, The Catholic University of Korea, Seoul, Korea.
authors.forename: Woo Hee
authors.initials: WH
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Lung Cancer Multidisciplinary Team, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors.forename: Eun Kyung
authors.initials: EK
authors.lastname: Jeon
authors.affiliation: Department of Internal Medicine, Lung Cancer Multidisciplinary Team, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors.forename: Suk Hee
authors.initials: SH
authors.lastname: Hong
authors.affiliation: Department of Internal Medicine, Lung Cancer Multidisciplinary Team, Bucheon St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Chun
authors.affiliation: Department of Internal Medicine, Lung Cancer Multidisciplinary Team, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors.forename: Seung Joon
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Lung Cancer Multidisciplinary Team, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors.forename: Young Kyoon
authors.initials: YK
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Lung Cancer Multidisciplinary Team, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. Electronic address: jinkang@catholic.ac.kr.
authors.forename: Jin Hyoung
authors.initials: JH
authors.lastname: Kang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000378:metabolism; D059248:Chemoradiotherapy / Q000401:mortality*; D002945:Cisplatin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D051272:Glucose Transporter Type 1 / Q000378:metabolism*; D006801:Humans; D051795:Hypoxia-Inducible Factor 1, alpha Subunit / Q000378:metabolism; D007124:Immunoenzyme Techniques; D008175:Lung Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism; D019275:Radiopharmaceuticals; D055752:Small Cell Lung Carcinoma / Q000378:metabolism* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
chemical_list: D014408:Biomarkers, Tumor; D051272:Glucose Transporter Type 1; C497442:HIF1A protein, human; D051795:Hypoxia-Inducible Factor 1, alpha Subunit; D019253:Proto-Oncogene Proteins c-bcl-2; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D005047:Etoposide; D002945:Cisplatin
keywords: Bcl-2; FDG-PET; GLUT-1; HIF-1α; Small-Cell Lung Cancer