High FDG uptake predicts poorer survival in locally advanced nonsmall cell lung cancer patients undergoing curative radiotherapy, independently of tumor size.
OBJECTIVE
Despite radical radiotherapy and chemotherapy (CT), the prognosis of locally advanced nonsmall cell lung cancer (NSCLC) is poor. New prognostic indicators are being looked forward to improve the survival. [18F]-fluorodeoxyglucose (FDG) uptake on PET/CT has been observed as a prognostic marker mainly in early-stage disease. Our aim was to examine the prognostic value of FDG uptake in locally advanced NSCLC.


METHODS
Between 2009 and 2011, 103 NSCLC patients underwent disease staging using FDG PET/CT before conformal radiotherapy. Thoracic radiation was administered at a daily fraction of 2 Gy. Total dose was prescribed according to the tumor response against CT. All patients underwent CT. Survival was estimated using the Kaplan-Meier method.


RESULTS
The median age of the patients was 59 years (range 39-83). The median follow-up time was 22.63 months (range 6-48.03 months). There was a statistically significant difference in overall survival (OS) between the low (<10.7) and high (≥10.7) standardized uptake value (SUVmax) groups (p = 0.006) on univariate analysis (3-year OS was 42% in the low (<10.7) and 23% in the high (≥10.7) SUVmax groups). On multivariate analysis with determining tumor size, tumor SUVmax provided additional significant prognostic information on OS (HR 1.046; 95 % CI 1.009-1.085, p = 0.015).


CONCLUSIONS
FDG uptake has predictive value in locally advanced NSCLC, independently of tumor size.
Department of Radiation Oncology, Faculty of Medicine, Gazi University Hospital, Gazi University, 06500, Besevler, Ankara, Turkey, ulgersukran@yahoo.com.
Sukran
S
Ulger
Nilgun Yilmaz
NY
Demirci
Fatma Nazan
FN
Eroglu
Huriye Hulya
HH
Cengiz
Mustafa
M
Tunc
Ebru
E
Tatci
Ulku
U
Yilmaz
Eren
E
Cetin
Emine
E
Avci
Mustafa
M
Cengiz
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000378:metabolism / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism*; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods; D011237:Predictive Value of Tests; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000378:metabolism*; D014057:Tomography, X-Ray Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18