title: FDG PET during radiochemotherapy is predictive of outcome at 1 year in non-small-cell lung cancer patients: a prospective multicentre study (RTEP2).
abstract: OBJECTIVE
  To assess prospectively the prognostic value of FDG PET/CT during curative-intent radiotherapy (RT) with or without concomitant chemotherapy in patients with non-small-cell lung cancer (NSCLC).
  
  
  METHODS
  Patients with histological proof of invasive localized NSCLC and evaluable tumour, and who were candidates for curative-intent radiochemotherapy (RCT) or RT were preincluded after providing written informed consent. Definitive inclusion was conditional upon significant FDG uptake before RT (PET₁). All included patients had a FDG PET/CT scan during RT (PET₂, mean dose 43 Gy) and were evaluated by FDG PET/CT at 3 months and 1 year after RT. The main endpoint was death (from whatever cause) or tumour progression at 1 year.
  
  
  RESULTS
  Of 77 patients preincluded, 52 were evaluable. Among the evaluable patients, 77% received RT with induction chemotherapy and 73% RT with concomitant chemotherapy. At 1 year, 40 patients (77 %) had died or had tumour progression. No statistically significant association was found between stage (IIIB vs. other), histology (squamous cell carcinoma vs. other), induction or concomitant chemotherapy, and death/tumour progression at 1 year. The SUVmax in the PET2 scan was the single variable predictive of death or tumour progression at 1 year (odds ratio 1.97, 95% CI 1.25 - 3.09, p = 0.003) in multivariate analysis. The area under the receiver operating characteristic curve was 0.85 (95% CI 0.73 - 0.94, p < 10(-4)). A SUVmax value of 5.3 in the PET₂ scan yielded a sensitivity of 70% and a specificity of 92% for predicting tumour progression or death at 1 year.
  
  
  CONCLUSIONS
  This prospective multicentre study demonstrated the prognostic value in terms of disease-free survival of SUVmax assessed during the 5th week of curative-intent RT or RCT in NSCLC patients (NCT01261598; RTEP2 study).
authors.affiliation: Department of Nuclear Medicine, Henri Becquerel Cancer Center, Henri Becquerel Center & QuantIF - Litis [EA (Equipe d'Accueil) 4108] & Rouen University Hospital, Rouen, France, pierre.vera@chb.unicancer.fr.
authors.forename: Pierre
authors.initials: P
authors.lastname: Vera
authors.forename: Sandrine
authors.initials: S
authors.lastname: Mezzani-Saillard
authors.forename: Agathe
authors.initials: A
authors.lastname: Edet-Sanson
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Ménard
authors.forename: Romain
authors.initials: R
authors.lastname: Modzelewski
authors.forename: Sebastien
authors.initials: S
authors.lastname: Thureau
authors.forename: Marc-Etienne
authors.initials: ME
authors.lastname: Meyer
authors.forename: Khadija
authors.initials: K
authors.lastname: Jalali
authors.forename: Stéphane
authors.initials: S
authors.lastname: Bardet
authors.forename: Delphine
authors.initials: D
authors.lastname: Lerouge
authors.forename: Claire
authors.initials: C
authors.lastname: Houzard
authors.forename: Françoise
authors.initials: F
authors.lastname: Mornex
authors.forename: Pierre
authors.initials: P
authors.lastname: Olivier
authors.forename: Guillaume
authors.initials: G
authors.lastname: Faure
authors.forename: Caroline
authors.initials: C
authors.lastname: Rousseau
authors.forename: Marc-André
authors.initials: MA
authors.lastname: Mahé
authors.forename: Philippe
authors.initials: P
authors.lastname: Gomez
authors.forename: Isabelle
authors.initials: I
authors.lastname: Brenot-Rossi
authors.forename: Naji
authors.initials: N
authors.lastname: Salem
authors.forename: Bernard
authors.initials: B
authors.lastname: Dubray
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000628:therapy; D059248:Chemoradiotherapy; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18