title: Prognositc significance of SUVmaxon pretreatment18F-FDG PET/CT in early-stage non-small cell lung cancer treated with stereotactic body radiotherapy: A meta-analysis.
abstract: BACKGROUND
  The prognostic importance of the18F-FDG PET maximum standardized uptake value (SUVmax) for early stage non-small cell lung cancer (NSCLC) patients receiving stereotactic body radiotherapy (SBRT) is not well defined. The purpose of this meta-analysis is to evaluate the efficacy of SUVmaxon pretreatment18F-FDG PET imaging to predict prognosis after SBRT.
  
  
  METHODS
  All published English-language studies that assessed the treatment response after SBRT in patients with early-stage NSCLC using18F-FDG PET were collected from the EMBASE and MEDLINE databases. All the included studies were published between January 2000 and June 2015 and limited to NSCLC, PET/CT, SBRT, and the impact of SUVmaxon survival. The necessary data for the calculation of individual hazard ratios (HRs) were extracted from each publication. All the results were independently verified and examined by two reviewers to ensure accuracy.
  
  
  RESULTS
  After evaluating the original articles, 11 retrospective studies (1008 patients) were included into the meta-analysis. Data were available in 11 studies for pre-SBRT primary tumour SUVmax. Seven studies (798 patients) were included for the overall survival (OS) analysis with a combined HR of 1.10 (95% CI, 1.05-1.15). Five studies (487 patients) were included for the local control analysis with a combined HR of 1.13 (95% CI, 1.06-1.21). Three studies (365 patients) were analysed for distant metastasis with a combined HR of 1.09 (95% CI, 1.03-1.16).
  
  
  CONCLUSIONS
  Patients with high levels of pre-SBRT SUVmaxhad poorer overall survival and local control and higher distant metastases. Further prospective studies are warranted to confirm the prognostic value of FDG uptake in early-stage NSCLC patients receiving SBRT.
authors.affiliation: Department of Radiation Oncology, Shandong Key Laboratory of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academic of Medicine Science, Jinan, Shandong, China.|Department of Oncology, Pingyi County People's Hospital, Linyi, Shandong, China.
authors.forename: Min
authors.initials: M
authors.lastname: Dong
authors.affiliation: Department of Radiation Oncology, Shandong Key Laboratory of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academic of Medicine Science, Jinan, Shandong, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Radiology, Shandong Key Laboratory of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academic of Medicine Science, Jinan, Shandong, China.
authors.forename: Xiaorong
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Radiation Oncology, Shandong Key Laboratory of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academic of Medicine Science, Jinan, Shandong, China.
authors.forename: Ligang
authors.initials: L
authors.lastname: Xing
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy*; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D000072078:Positron Emission Tomography Computed Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals; D016634:Radiosurgery / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: maximum standardized uptake value; meta-analysis; non-small cell lung cancer; prognosis; stereotactic body radiotherapy