title: Early assessment of metabolic response by 18F-FDG PET during concomitant radiochemotherapy of non-small cell lung carcinoma is associated with survival: a retrospective single-center study.
abstract: OBJECTIVE
  We performed a retrospective single-center study to assess if midtreatment 18F-FDG PET/CT could predict local control and survival in patients with locally advanced non-small cell lung cancer treated with concurrent chemoradiotherapy.
  
  
  METHODS
  Thirty-one consecutive patients with unresectable or locally advanced lung cancer (T2-4 N0-3 M0) were treated with concurrent chemoradiotherapy in our center. Each patient received 18F-FDG PET/CT before treatment and at midtreatment time when a radiation therapy dose of 30 Gy was delivered. We assessed several PET/CT parameters as follows: SUV max, ΔSUV mean, ΔSUV max, variation of hypermetabolic tumor volume, and the variation of tumor total lesion glycolysis (ΔTLG). Univariate analysis was performed, and a stepwise procedure was used to define final multivariate model.
  
  
  RESULTS
  The ΔTLG was statistically correlated to overall survival (OS) (P = 0.035), progression-free survival (P = 0.023), and local control (P = 0.043) in univariate analysis. A decrease in TLG over 15% was statistically correlated to a better OS (P = 0.007; hazards ratio [HR], 7.439; 95% confidence interval [CI], 1.168-28.897) and progression-free survival (P = 0.010; HR, 5.695; 95% CI, 1.506-21.537) in univariate analysis. In multivariate analysis, ΔTLG superior to -15% was significantly correlated to a worse OS (P = 0.020; HR, 5.973; 95% CI, 1.324-26.953).
  
  
  CONCLUSIONS
  Early assessment of TLG response by 18F-FDG PET/CT during concomitant radiochemotherapy of non-small cell lung cancer might be associated with survival.
authors.affiliation: From the *Centre Jean Bernard, Clinique Victor Hugo, Le Mans; †Département de Radiothérapie, and ‡Délégation à la Recherche Clinique et à l'Innovation, Institut de Cancérologie de l'Ouest Paul Papin, Angers; and §Unité de Biostatistique, Département Recherche, Institut de Cancérologie de l'Ouest Gauducheau, Nantes, France.
authors.forename: Séna
authors.initials: S
authors.lastname: Yossi
authors.forename: Samar
authors.initials: S
authors.lastname: Krhili
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Muratet
authors.forename: Anne-Lise
authors.initials: AL
authors.lastname: Septans
authors.forename: Loïc
authors.initials: L
authors.lastname: Campion
authors.forename: Fabrice
authors.initials: F
authors.lastname: Denis
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000628:therapy; D059248:Chemoradiotherapy; 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; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18