title: Metabolic tumor volume on FDG-PET/CT is a possible prognostic factor for Stage I lung cancer patients treated with stereotactic body radiation therapy: a retrospective clinical study.
abstract: The aim of this study was to determine whether metabolic tumor volume (MTV) and total lesion glycolysis (TLG) are associated with outcomes in Stage I lung cancer patients treated with stereotactic body radiation therapy (SBRT). Thirty-eight patients underwent [18F] fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) within 60 days before SBRT at our institution between January 2001 and December 2011. The maximum standardized uptake value (SUVmax), MTV2, MTV4, MTV6, TLG40%, TLG50%and TLG60%were calculated. Prognostic factors for overall survival (OS) and local control (LC) were analyzed using Cox's proportional hazards model, and survival curves were calculated using the Kaplan-Meier method. Receiver operating characteristics (ROC) curves of PET parameters for OS and LC were calculated. The median follow-up period for survivors was 37.7 months. Three-year OS and LC rates were 56.4% and 70.5%, respectively, and 5-year OS and LC rates were 36.8% and 70.5%, respectively. In univariate analyses, tumor diameter (P = 0.019), single dose ≥10 Gy (P = 0.017), MTV2(P = 0.030) and MTV4(P = 0.048) were significant predictors for OS. Tumor diameter (P < 0.001), single dose ≥10 Gy (P = 0.007), SUVmax(P = 0.035), MTV2(P < 0.001), MTV4(P = 0.003), MTV6(P = 0.017), TLG40%(P < 0.001), TLG50%(P = 0.001) and TLG60%(P = 0.003) were significant predictors for LC. SUVmax was not a significant predictor for OS. We made the ROC curves at PET parameters, and the largest area under the curve value for OS was MTV2and for LC was TLG40%Tumor diameter, single dose ≥10 Gy, MTV2 and MTV4are prognostic factors for OS and LC rates and MTV2is a better prognostic factor for OS than other PET parameters.
authors.affiliation: Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan noriyoshi.08.25@gmail.com.
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Takahashi
authors.affiliation: Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Takaya
authors.initials: T
authors.lastname: Yamamoto
authors.affiliation: Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Haruo
authors.initials: H
authors.lastname: Matsushita
authors.affiliation: Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Sugawara
authors.affiliation: Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Kubozono
authors.affiliation: Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Rei
authors.initials: R
authors.lastname: Umezawa
authors.affiliation: Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Yojiro
authors.initials: Y
authors.lastname: Ishikawa
authors.affiliation: Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Maiko
authors.initials: M
authors.lastname: Kozumi
authors.affiliation: Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Katagiri
authors.affiliation: Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Syun
authors.initials: S
authors.lastname: Tasaka
authors.affiliation: Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Takeda
authors.affiliation: Department of Radiological Technology, School of Health Sciences, Faculty of Medicine, Tohoku University, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Takeda
authors.affiliation: Department of Radiological Technology, School of Health Sciences, Faculty of Medicine, Tohoku University, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Suguru
authors.initials: S
authors.lastname: Dobashi
authors.affiliation: Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Jingu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography; D011379:Prognosis; D012372:ROC Curve; D016634:Radiosurgery; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: NSCLC; metabolic tumor volume; non–small cell lung cancer; prognostic factor; stereotactic body radiation therapy; total lesion glycolysis