Standardised FDG uptake: A prognostic factor for inoperable non-small cell lung cancer

Borst, Gerben R.; Belderbos, José S.A.; Boellaard, Ronald; Comans, Emile F.I.; Jaeger, Katrien De; Lammertsma, Adriaan A.; Lebesque, Joos V.

doi:10.1016/j.ejca.2005.03.026

« Previous Next »European Journal of Cancer
Volume 41, Issue 11 , Pages 1533-1541, July 2005

Standardised FDG uptake: A prognostic factor for inoperable non-small cell lung cancer

Gerben R. Borst
- Department of Radiation Oncology, The Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
José S.A. Belderbos
- Department of Radiation Oncology, The Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
Ronald Boellaard
- Clinical PET Centre, VU University Medical Centre, Amsterdam, The Netherlands
Emile F.I. Comans
- Clinical PET Centre, VU University Medical Centre, Amsterdam, The Netherlands
Katrien De Jaeger
- Department of Radiation Oncology, The Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
Adriaan A. Lammertsma
- Clinical PET Centre, VU University Medical Centre, Amsterdam, The Netherlands
Joos V. Lebesque
- Department of Radiation Oncology, The Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
- Corresponding author. Tel.: +31 20 5122139; fax: +31 20 6691101.

Received 25 February 2005; received in revised form 29 March 2005; accepted 31 March 2005.

Abstract

The aim of this study was to investigate the relationship between standardised uptake value (SUV) obtained from [¹⁸F]fluorodeoxyglucose positron emission tomography (FDG PET) and treatment response/survival of inoperable non-small cell lung cancer (NSCLC) patients treated with high dose radiotherapy. Fifty-one patients were included recording stage, performance, weight loss, tumour volume, histology, lymph node involvement, SUV, and delivered radiation dose. The maximum SUV (SUV_max) within the primary tumour was a sensitive and specific factor for predicting treatment response. Apart from SUV_max, stage and performance were also independent predictive factors for treatment response. In a multivariate disease-specific survival (DSS) analysis, SUV_max (P=0.01), performance status (P=0.008) and stage (P=0.04) were prognostic factors. For overall survival (OS), SUV_max (P=0.001) and performance (P=0.06) were important prognostic factors. SUV_max was an important prognostic factor for survival of inoperable NSCLC patients and a predictive factor for treatment response. Although the number of patients was small, the treatment was not homogeneous and the use of FDG SUV may have had constraints, we still conclude that the FDG SUV is potentially a good indicator for selecting patients for different treatment strategies.