Prognostic value of (18) F-fluoroazomycin arabinoside PET/CT in patients with advanced non-small-cell lung cancer.
This study evaluated the prognostic value of positron emission tomography/computed tomography (PET/CT) using (18) F-fluoroazomycin arabinoside (FAZA) in patients with advanced non-small-cell lung cancer (NSCLC) compared with (18) F-fluorodeoxyglucose (FDG). Thirty-eight patients with advanced NSCLC (stage III, 23 patients; stage IV, 15 patients) underwent FAZA and FDG PET/CT before treatment. The PET parameters (tumor-to-muscle ratio [T/M] at 1 and 2 h for FAZA, maximum standardized uptake value for FDG) in the primary lesion and lymph node (LN) metastasis and clinical parameters were compared concerning their effects on progression-free survival (PFS) and overall survival (OS). In our univariate analysis of all patients, clinical stage and FAZA T/M in LNs at 1 and 2 h were predictive of PFS (P = 0.021, 0.028, and 0.002, respectively). Multivariate analysis also indicated that clinical stage and FAZA T/M in LNs at 1 and 2 h were independent predictors of PFS. Subgroup analysis of chemoradiotherapy-treated stage III patients revealed that only FAZA T/M in LNs at 2 h was predictive of PFS (P = 0.025). The FDG PET/CT parameters were not predictive of PFS. No parameter was a significant predictor of OS. In patients with advanced NSCLC, FAZA uptake in LNs, but not in primary lesions, was predictive of treatment outcome. These results suggest the importance of characterization of LN metastases in advanced NSCLC patients.
Molecular Imaging Center, National Institute of Radiological Sciences, Chiba, Japan.
Tsuneo
T
Saga
Department of Nuclear Medicine, Kawasaki Medical School, Kurashiki, Japan.
Masayuki
M
Inubushi
Department of Nuclear Medicine, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Mitsuru
M
Koizumi
Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan.
Kyosan
K
Yoshikawa
Molecular Imaging Center, National Institute of Radiological Sciences, Chiba, Japan.
Ming-Rong
MR
Zhang
Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan.
Katsuyuki
K
Tanimoto
Department of Thoracic Medical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Atsushi
A
Horiike
Department of Thoracic Medical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Noriko
N
Yanagitani
Department of Thoracic Medical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Fumiyoshi
F
Ohyanagi
Department of Thoracic Medical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Makoto
M
Nishio
D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000494:pharmacology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009593:Nitroimidazoles / Q000494:pharmacology; D049268:Positron-Emission Tomography; D011379:Prognosis; D016016:Proportional Hazards Models; D019275:Radiopharmaceuticals / Q000494:pharmacology; D014057:Tomography, X-Ray Computed
D009593:Nitroimidazoles; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; C498052:fluoroazomycin arabinoside
18F-fluoroazomycin arabinoside (FAZA); 18F-fluorodeoxyglucose (FDG); non-small-cell lung cancer; positron emission tomography/computed tomography (PET/CT); prognosis