title: Stereotactic Ablative Radiation Therapy for Lung Oligometastases: Predictive Parameters of Early Response by18FDG-PET/CT.
abstract: The objective of this study was to investigate fludeoxyglucose F 18 positron emission tomography/computed tomography (18FDG-PET/CT) parameters as predictive of response after stereotactic ablative radiotherapy (SABR) for lung oligometastases.
  
  
  
  The inclusion criteria of the current retrospective study were as follows: (1) lung oligometastases treated by SABR, (2) presence of18FDG-PET/CT before and after SABR for at least two subsequent evaluations, (3) Karnofsky performance status higher than 80, and (4) life expectancy longer than 6 months. All patients were treated with a biologically equivalent dose of at least 100 Gy with an alpha/beta ratio of 10. The following metabolic parameters were semiquantitatively defined: maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume, and total lesion glycolysis.
  
  
  
  A total of 50 patients met the inclusion criteria, for a total of 70 lung metastases. The pre-SABR median SUVmaxwas 6.5 (range 4-17), the median SUVmeanwas 3.7 (range 2.5-6.5), and the median metabolic tumor volume was 2.3 cm3(0.2-31 cm3). The following metabolic parameters were significantly related to complete response at 6 months: SUVmaxless than 5 (p < 0.001) and SUVmeanless than 3.5 (p = 0.03). ΔSUVmaxat 3 to 6 months was +126% for lesions with in-field progression versus -26% for the remaining lesions (p = 0.002). ΔSUVmeanat 3 to 6 months was +15% for lesions with in-field progression versus -26% for the remaining metastases (p = 0.008).
  
  
  
  In the current analysis, complete response from lung metastasis at 6 months after stereotactic body radiation therapy was significantly associated with both the maximum and mean values of pre-SABR18FDG-PET/CT SUV. Longer-term trials are strongly advocated to improve the personalization of the monitoring of tumor response in patients with lung oligometastases and, consequently, monitoring of the cost-effectiveness of the health care.
authors.affiliation: Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy. Electronic address: rosariomazzola@hotmail.il.
authors.forename: Rosario
authors.initials: R
authors.lastname: Mazzola
authors.affiliation: Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy.
authors.forename: Alba
authors.initials: A
authors.lastname: Fiorentino
authors.affiliation: Statistic Sciences Faculty, University of Palermo, Palermo, Italy.
authors.forename: Gioacchino
authors.initials: G
authors.lastname: Di Paola
authors.affiliation: Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy.
authors.forename: Niccolò
authors.initials: N
authors.lastname: Giaj Levra
authors.affiliation: Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Ricchetti
authors.affiliation: Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Fersino
authors.affiliation: Radiation Oncology School, University of Padua, Padua, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Tebano
authors.affiliation: Nuclear Medicine, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Pasetto
authors.affiliation: Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy.
authors.forename: Ruggero
authors.initials: R
authors.lastname: Ruggieri
authors.affiliation: Nuclear Medicine, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Salgarello
authors.affiliation: Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Alongi
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000378:metabolism / Q000556:secondary / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000556:secondary / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000378:metabolism / Q000556:secondary / Q000601:surgery; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism*; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000378:metabolism; D016634:Radiosurgery; D012189:Retrospective Studies; D047368:Tumor Burden
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: (18)FDG-PET/CT; Lung malignancies; Predictive factors; SABR