title: Utility of Routine PET Imaging to Predict Response and Survival After Induction Therapy for Non-Small Cell Lung Cancer.
abstract: BACKGROUND
  Data from clinical trials suggest that changes in the glucose avidity of the primary site of lung cancer during induction therapy, measured by changes in (18)F-fluorodeoxyglucose positron emission tomography, correlate with tumor response. Little information about the utility of changes in positron emission tomography imaging of involved lymph nodes during induction chemotherapy is available. The utility of positron emission tomography imaging of either the primary site or nodal metastases, obtained during routine clinical care outside of a clinical trial setting, to predict response has also not been examined.
  
  
  METHODS
  A retrospective review of all surgical patients with non-small cell lung cancer at a single institution imaged between 2000 and 2006 with (18)F-fluorodeoxyglucose positron emission tomography before or after induction therapy was performed.
  
  
  RESULTS
  An increase in standardized uptake value in the primary site of disease during induction therapy was associated with reduced overall survival after resection. Neither pretreatment standardized uptake value nor percentage change in the primary site was associated with overall survival after resection. A decrease in standardized uptake value of greater than 60% in the involved N2 mediastinal nodes was the best predictor of overall survival, better than changes seen in the primary site of disease.
  
  
  CONCLUSIONS
  An increase in glucose avidity of non-small cell lung cancers during induction therapy was associated with a worse prognosis compared with stable or any decrease in standardized uptake value. Changes in the glucose avidity of mediastinal nodal metastases may be a stronger predictor of survival than changes in the primary site of disease.
authors.affiliation: Thoracic Service, Department of Surgery, Memorial Hospital, Memorial Sloan Kettering Cancer Center, New York.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Barnett
authors.affiliation: Thoracic Service, Department of Surgery, Memorial Hospital, Memorial Sloan Kettering Cancer Center, New York; Weill Cornell Medical College, New York, New York. Electronic address: downeyr@mskcc.org.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Downey
authors.affiliation: Weill Cornell Medical College, New York, New York; Department of Epidemiology and Biostatistics, Memorial Hospital, Memorial Sloan Kettering Cancer Center, New York.
authors.forename: Junting
authors.initials: J
authors.lastname: Zheng
authors.affiliation: Thoracic Service, Department of Surgery, Memorial Hospital, Memorial Sloan Kettering Cancer Center, New York.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Plourde
authors.affiliation: Weill Cornell Medical College, New York, New York; Department of Epidemiology and Biostatistics, Memorial Hospital, Memorial Sloan Kettering Cancer Center, New York.
authors.forename: Ronglai
authors.initials: R
authors.lastname: Shen
authors.affiliation: Weill Cornell Medical College, New York, New York; Thoracic Oncology Service, Department of Medicine, Memorial Hospital, Memorial Sloan Kettering Cancer Center, New York.
authors.forename: Jamie
authors.initials: J
authors.lastname: Chaft
authors.affiliation: Weill Cornell Medical College, New York, New York; Nuclear Medicine Service, Department of Radiology, Memorial Hospital, Memorial Sloan Kettering Cancer Center, New York.
authors.forename: Timothy
authors.initials: T
authors.lastname: Akhurst
authors.affiliation: Thoracic Service, Department of Surgery, Memorial Hospital, Memorial Sloan Kettering Cancer Center, New York; Weill Cornell Medical College, New York, New York.
authors.forename: Bernard J
authors.initials: BJ
authors.lastname: Park
authors.affiliation: Thoracic Service, Department of Surgery, Memorial Hospital, Memorial Sloan Kettering Cancer Center, New York; Weill Cornell Medical College, New York, New York.
authors.forename: Valerie W
authors.initials: VW
authors.lastname: Rusch
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009518:New York / Q000453:epidemiology; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data*; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends