title: The early predictive value of a decrease of metabolic tumor volume in repeated (18)F-FDG PET/CT for recurrence of locally advanced non-small cell lung cancer with concurrent radiochemotherapy.
abstract: OBJECTIVE
  The aim of this study is to investigate the value of [(18)F] fluorodeoxyglucose positron emission tomography/computed tomography ((18)F FDG PET/CT) to predict recurrence of patients with locally advanced non-small cell lung cancer (NSCLC) during the early stage of concurrent chemoradiotherapy (CCRT).
  
  
  METHODS
  A total of 53 stage III NSCLC patients without diabetics or undergoing surgery were enrolled in the prospective study. Those patients were evaluated by FDG PET before and following 40Gy radiotherapy (RT) with a concurrent cisplatin-based heterogeneous chemotherapy regimen. Semiquantitative assessment was used to determine maximum and mean SUVs (SUVmax/SUVmean) and metabolic tumor volume (MTV) of the primary tumor. The prognostic significance of PET/CT parameters and other clinical variables was assessed using Cox regression analyses. The cutoffs of PET/CT parameters which have been determined by the previous study were used to separate the groups with Kaplan-Meier curves.
  
  
  RESULTS
  Recurrence rates at 1- and 2-years were 18.9% (10/53) and 50.9% (27/53) for all patients, respectively. Cox regression analysis showed that the only prognostic factor for recurrence was a decrease of MTV. Using the cutoff of 29.7%, a decrease of MTV can separate the patients into 2 groups with Kaplan-Meier curve successfully.
  
  
  CONCLUSIONS
  The prospective study has reinforced the early predictive value of MTV in repeated (18)F-FDG PET/CT for recurrence in a subgroup of locally advanced NSCLC who underwent CCRT. A decrease of MTV in (18)F-FDG uptake by the primary tumor correlates with higher LRFS.
authors.affiliation: Department of Radiation Oncology (Chest Section), Shandong's Key Laboratory of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan 250117, PR China. Electronic address: weihuang@mcw.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Huang
authors.affiliation: Department of Internal Medicine Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan, PR China.
authors.forename: Bo
authors.initials: B
authors.lastname: Liu
authors.affiliation: Department of Internal Medicine Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan, PR China.
authors.forename: Min
authors.initials: M
authors.lastname: Fan
authors.affiliation: Department of Radiation Oncology (Chest Section), Shandong's Key Laboratory of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan 250117, PR China.
authors.forename: Tao
authors.initials: T
authors.lastname: Zhou
authors.affiliation: PET/CT center, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan, PR China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Fu
authors.affiliation: Department of Radiation Oncology (Chest Section), Shandong's Key Laboratory of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan 250117, PR China.
authors.forename: Zicheng
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Radiation Oncology (Chest Section), Shandong's Key Laboratory of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan 250117, PR China.
authors.forename: Hongsheng
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Radiation Oncology (Chest Section), Shandong's Key Laboratory of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan 250117, PR China. Electronic address: alvinbird@163.com.
authors.forename: Baosheng
authors.initials: B
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000473:pathology; D059248:Chemoradiotherapy; D002945:Cisplatin; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D049268:Positron-Emission Tomography; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden
chemical_list: D019788:Fluorodeoxyglucose F18; D002945:Cisplatin
keywords: FDG; Non-small cell lung cancer; PET; Recurrence