Richard Alan Laine MD, Presenter: Nothing to Disclose

Karen J Wells, Abstract Co-Author: Nothing to Disclose

Robert Eric Heidel, Abstract Co-Author: Nothing to Disclose

Josh Schaeferkotter, Abstract Co-Author: Nothing to Disclose

Misty J Long,, Abstract Co-Author: Nothing to Disclose

Wahid Hanna, Abstract Co-Author: Nothing to Disclose

Karl F. Hubner MD, Abstract Co-Author: Nothing to Disclose

18F-FDG PET/CT performed after 8, 22, and 36 days after initiation of platinum based chemotherapy may be predictive of non-small cell lung cancer tumor metabolic response and length of patient survival.

We studied 36 patients with newly diagnosed non-small cell lung cancer who received a platinum-based initial chemotherapy regimen.  Each patient was studied at 8 days, 22 days, and 36 days after initiation of chemotherapy, and primary lung tumor tissue activity was assessed by the amount of radioactivity retained 90 minutes after the intravenous injection of 18F-FDG. All patients exhibited a hypermetabolic primary lung tumor with a standard uptake value (SUV) of greater than 2 on 18F-FDG-PET as an inclusion criteria for analysis. In a prospective analysis, we evaluated the time course of mean metabolic activity in the primary tumor. A metabolic response was defined as a tumor response in which there was a 20% or greater reduction in SUV between day 8 and day 36 PET studies. Independent samples T-test evaluated differences in survival between metabolic responders (group 1) and non-responders (group 2).  Kaplan-Meier and Breslow's analysis  were performed to assess differences in survival time between groups.

35 of 36 patients completed all 3 18F-FDG PET studies, 1 patient accomplished only days 8 and 36 PET studies. Median clinical follow up was 491 days (range, 102-1553 days).  20 patients were classified as metabolic responders based on a 20% or greater decrease in mean SUV on day 36 PET from baseline, with a mean survival of 756 days.  16 patients were nonresponders, with a mean survival of 467days. Metabolic responders lived significantly longer than metabolic nonresponders, p = 0.05 (independent samples T-test).  Kaplan-Meier survival analysis demonstrated a significant difference in survival time between responders and non-responders, p = 0.016.

In patients with non-small cell lung cancer, a tumor metabolic response on 18F-FDG PET/CT studies performed 8 and 36 days post chemotherapy was a significant predictor of survival time.

18F-FDG PET/CT can predict non-small cell lung cancer tumor metabolic response and length of survival when performed 1 and 5 weeks after initiation of standard chemotherapy.

Laine, R, Wells, K, Heidel, R, Schaeferkotter, J, Long,, M, Hanna, W, Hubner, K, Early Prediction of Response to Chemotherapy in Non-Small Cell Lung Cancer Patients Using 18F-FDG PET/CT.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11013110.html