Nodal metabolic tumour volume on baseline 18F-FDG PET/CT and overall survival in stage II and III NSCLC patients undergoing curative-intent chemoradiotherapy/radiotherapy

Alipour, R; Bucknell, N; Bressel, M; Everitt, S; MacManus, M; Siva, S; Hofman, MS; Akhurst, T; Hicks, RJ; Iravani, A

Author(s): Alipour, R; Bucknell, N; Bressel, M; Everitt, S; MacManus, M; Siva, S; Hofman, MS; Akhurst, T; Hicks, RJ; Iravani, A;
Details: Publication Year 2021-10,Volume 65,Issue #6,Page 748-754
Journal Title: Journal of Medical Imaging and Radiation Oncology
Publication Type: Research article
Abstract: INTRODUCTION: This study aims to investigate whether nodal metabolic tumour volume (nMTV) and nodal total lesion glycolysis (nTLG) on Fluorine-18 fluoro-deoxy-glucose positron emission tomography-computed tomography ((18) F-FDG PET/CT) in inoperable node-positive stage II and III non-small cell lung cancer (NSCLC) are independent predictors of overall survival (OS) in patients undergoing curative-intent chemoradiotherapy/radiotherapy (CRT/RT). METHODS: Data from two prospective trials between 2004 and 2016 were analysed retrospectively. Primary, nodal and total metabolic tumour volume and total lesion glycolysis (pMTV, nMTV, tMTV, pTLG, nTLG and tTLG, respectively) were derived from baseline (18) F-FDG PET/CT. Cox regressions were used to model OS by (18) F-FDG PET/CT parameters adjusting for overall stage. RESULTS: 89 patients with stage II (8%) and stage III (92%) were included. The median age at diagnosis was 67 years; 62% were male. The median follow-up was 6.9 years; the median OS was 2.2 years (95% CI 1.7-3.1). The median pMTV, nMTV and tMTV were 14 mL (range 0-360), 8 mL (range 0-250) and 34 mL (range 3-384), respectively. In 3 patients, the primary lesion could not be delineated from the central hilar mass. There was no association between nMTV (adjusted HR 1.04, 95% CI 0.95-1.15, P-value 0.43), pMTV (adjusted HR 1.0, 95% CI 0.96-1.04, P-value 0.92), tMTV (adjusted HR 1.0, 95% CI 0.97-1.04, P-value 0.88), nTLG, pTLG or tTLG and OS. Consistent results were noted when patients with central hilar lesions were excluded from analysis. CONCLUSION: In node-positive stage II and III NSCLC patients who underwent (18) F-FDG PET/CT-guided target delineation curative-intent concurrent CRT/RT, metabolic parameters did not appear to provide independent prognostication.
Keywords: *Carcinoma, Non-Small-Cell Lung/diagnostic imaging/therapy; Chemoradiotherapy; Fluorodeoxyglucose F18; Humans; *Lung Neoplasms/diagnostic imaging/therapy; Male; Positron Emission Tomography Computed Tomography; Prognosis; Prospective Studies; Retrospective Studies; Tumor Burden; 18f-fdg pet/ct; curative-intent chemoradiotherapy; nMTV; overall survival; stage II/III NSCLC
Department(s): Cancer Imaging; Radiation Oncology; Biostatistics and Clinical Trials; Radiation Therapy
PubMed ID: 34318603
Publisher's Version: https://doi.org/10.1111/1754-9485.13294
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2025-05-23 04:02:52

Last Modified: 2025-05-23 04:04:10