title: 111In-Pentetreotide (OctreoScan) scintigraphy in the staging of small-cell lung cancer: its accuracy and prognostic significance.
abstract: BACKGROUND
  Small-cell lung cancer (SCLC) may express somatostatin transmembrane receptors (SSTRs) in 50-75% of cases. We evaluated the accuracy and prognostic significance of somatostatin receptor scintigraphy (SSRS) in staging compared with conventional radiological procedures.
  
  
  METHODS
  Newly diagnosed SCLC patients underwent scintigraphy with the radiolabeled somatostatin analog indium-111 (In)-pentetreotide (OctreoScan). Histological data were available for 20 (38%) patients for immunohistochemical analysis of SSTR-2 expression.
  
  
  RESULTS
  From May 2007 to December 2011 we analyzed 52 SCLC patients. In comparison with standard radiologic staging, the sensitivity and specificity of SSRS were 63 and 100% for primary pulmonary tumor (T), 51 and 100% for mediastinal lymph node (N), and 23 and 91% for metastatic disease (M), respectively. The overall SSRS accuracy was 65% for T, 62% for N, and 52% for M. Patients with positive SSRS achieved a disease control rate of 97 versus 84% in those with negative exam results; median progression-free survival was 9.5 months versus 11.0 and median overall survival was 15.3 versus 14.5 months for patients with positive SSRS versus those with a negative result. Notably, seven (78%) patients with a positive quantitative analysis for SSTR-2 had a positive SSRS; at semiquantitative analysis this correlation was found in eight (73%) patients.
  
  
  CONCLUSIONS
  SSRS has a lower accuracy in comparison with standard radiological staging in SCLC. However, patients with a positive SSRS given standard treatments showed better disease control compared with those with a negative SSRS, but similar progression-free survival and overall survival.
authors.affiliation: aDepartment of Clinical Oncology, Cervesi Hospital, Cattolica bDepartment of Medical Oncology cRadiology Unit dUnit of Biostatistics and Clinical Trials eBiosciences Laboratory fDiagnostic Nuclear Medicine Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola gNuclear Medicine Unit hPathology Unit, Morgagni-Pierantoni Hospital, Forlì, Italy.
authors.forename: Giovenzio
authors.initials: G
authors.lastname: Genestreti
authors.forename: Alberto
authors.initials: A
authors.lastname: Bongiovanni
authors.forename: Marco Angelo
authors.initials: MA
authors.lastname: Burgio
authors.forename: Salvatore Luca
authors.initials: SL
authors.lastname: Burgio
authors.forename: Alessandra
authors.initials: A
authors.lastname: Musto
authors.forename: Alice
authors.initials: A
authors.lastname: Rossi
authors.forename: Manuela
authors.initials: M
authors.lastname: Monti
authors.forename: Emanuela
authors.initials: E
authors.lastname: Scarpi
authors.forename: Paola
authors.initials: P
authors.lastname: Ulivi
authors.forename: Sara
authors.initials: S
authors.lastname: Bravaccini
authors.forename: Alessandra
authors.initials: A
authors.lastname: Dubini
authors.forename: Federica
authors.initials: F
authors.lastname: Matteucci
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Gavelli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D011379:Prognosis; D017481:Receptors, Somatostatin / Q000378:metabolism; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055752:Small Cell Lung Carcinoma / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology*; D013004:Somatostatin / Q000031:analogs & derivatives*; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
chemical_list: D017481:Receptors, Somatostatin; D013004:Somatostatin; C081788:pentetreotide