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Clinical and Translational Oncology

, Volume 21, Issue 4, pp 499–504 | Cite as

Effect of PET/CT standardized uptake values on complete response to treatment before definitive chemoradiotherapy in stage III non-small cell lung cancer

  • O. ErcelepEmail author
  • O. Alan
  • D. Sahin
  • T. A. Telli
  • H. Salva
  • T. B. Tuylu
  • N. A. Babacan
  • S. Kaya
  • F. Dane
  • T. Ones
  • H. Alkis
  • M. Adli
  • F. Yumuk
Research Article
  • 100 Downloads

Abstract

Purpose

The standard treatment for patients with stage III non-small cell lung cancer (NSCLC), unsuitable for resection and with good performance, is definitive radiotherapy with cisplatin-based chemotherapy. Our aim is to evaluate the effect of the maximum value of standardized uptake values (SUVmax) of the primary tumor in positron emission tomography-computed tomography (PET/CT) before treatment on complete response (CR) and overall survival.

Methods

The data of 73 stage III NSCLC patients treated with concurrent definitive chemoradiotherapy (CRT) between 2008 and 2017 and had PET/CT staging in the pretreatment period were evaluated. ROC curve analysis was performed to determine the ideal cut-off value of pretreatment SUVmax to predict CR.

Results

Median age was 58 years (range 27–83 years) and 66 patients were male (90.4%). Median follow-up time was 18 months (range 3–98 months); median survival was 23 months. 1-year overall survival (OS) rate and 5-year OS rate were 72 and 19%, respectively. Median progression-free survival (PFS) was 9 months; 1-year PFS rate and 5-year PFS rate were 38 and 19%, respectively. The ideal cut-off value of pretreatment SUVmax that predicted the complete response of CRT was 12 in the ROC analysis [AUC 0.699 (0.550–0.833)/P < 0.01] with a sensitivity of 83%, and specificity of 55%. In patients with SUVmax < 12, CR rate was 60%, while, in patients with SUV ≥ 12, it was only 19% (P = 0.002). Median OS was 26 months in patients with pretreatment SUVmax < 12, and 21 months in patients with SUVmax ≥ 12 (HR = 2.93; 95% CI 17.24–28.75; P = 0.087). CR rate of the whole patient population was 26%, and it was the only factor that showed a significant benefit on survival in both univariate and multivariate analyses.

Conclusion

Pretreatment SUVmax of the primary tumor in PET/CT may predict CR in stage III NSCLC patients who were treated with definitive CRT. Having clinical CR is the only positive predictive factor for prolonged survival.

Keywords

Stage III Non-small cell lung cancer Chemoradiotherapy PET/CT SUVmax 

Notes

Compliance with ethical standards

Conflict of interest

None

Research involving human participants and/or animals

Not applicable, since the study was retrospective.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all participants included in the study.

Ethics/institutional review board approval of research

Faculty of Medicine, Marmara University, Istanbul, Turkey. Number: 09.2018.281 Date: 07.05.2018.

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Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2018

Authors and Affiliations

  1. 1.Department of Medical Oncology, Pendik Education and Research HospitalMarmara UniversityIstanbulTurkey
  2. 2.Department of Medical Oncology, Faculty of MedicineMarmara UniversityIstanbulTurkey
  3. 3.Department of Internal Medicine, Faculty of MedicineMarmara UniversityIstanbulTurkey
  4. 4.Department of Nuclear Medicine, Faculty of MedicineMarmara UniversityIstanbulTurkey
  5. 5.Department of Radiation Oncology, Faculty of MedicineMarmara UniversityIstanbulTurkey

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