Abstract
PurposeThe study aims to investigate the role of 18F-alfatide positron emission tomography/computed tomography (PET/CT) in predicting the short-term outcome of concurrent chemoradiotherapy (CCRT) in patients with advanced non-small cell lung cancer (NSCLC).MethodsEighteen patients with advanced NSCLC had undergone 18F-alfatide PET/CT scans before CCRT and PET/CT parameters including maximum and mean standard uptake values (SUVmax/SUVmean), peak standard uptake values (SUVpeak) and tumor volume (TVPET and TVCT) were obtained. The SUVmax of tumor and normal tissues (lung, blood pool and muscle) were measured, and their ratios were denoted as T/NT (T/NTlung, T/NTblood and T/NTmuscle). Statistical methods included the Two-example t test, Wilcoxon rank-sum test, Receiver-operating characteristic (ROC) curve analysis and logistic regression analyses.ResultsWe found that SUVmax, SUVpeak, T/NTlung, T/NTblood and T/NTmuscle were higher in non-responders than in responders (P = 0.0024, P = 0.016, P < 0.001, P = 0.003, P = 0.004). According to ROC curve analysis, the thresholds of SUVmax, SUVpeak, T/NTlung, T/NTblood and T/NTmuscle were 5.65, 4.46, 7.11, 5.41, and 11.75, respectively. The five parameters had high sensitivity, specificity and accuracy in distinguishing non-responders and responders. Multivariate logistic regression analyses showed that T/NTlung was an independent predictor of the short-term outcome of CCRT in patients with advanced NSCLC (P = 0.032).Conclusions 18F-alfatide PET/CT may be useful in predicting the short-term outcome of CCRT in patients with advanced NSCLC.
Highlights
Lung cancer is the leading cause of cancer death worldwide, and non-small cell lung cancer (NSCLC) accounts for 85 % [1]
All patients had given informed consent to participate in this study, which was approved by the ethics committee of Shandong Cancer Hospital affiliated to Shandong University and met the following inclusion criteria: (1) advanced NSCLC diagnosed by histological and imaging examination such as CT or 18F-fluorodeoxyglucose (FDG) PET/CT; (2) Karnofsky performance status (KPS) ≥70; (3) had measurable primary tumors according to Response Evaluation Criteria in Solid Tumors (RECIST)
Nine patients were classified as responders (52 %), including one complete response, eight partial responses, and nine patients were classified as nonresponders (48 %) including eight stable disease and one progressive disease
Summary
Lung cancer is the leading cause of cancer death worldwide, and non-small cell lung cancer (NSCLC) accounts for 85 % [1]. One-third of patients with newly diagnosed NSCLC have been advanced and not amenable for curative resection. Concurrent chemoradiotherapy (CCRT) represents the standard of therapy protocol for patients with advanced NSCLC who have good performance status and no significant weight loss [2]. Even with the standard therapy, one-third of these patients still experience local failure [3]. It’s important to find an effective predicting tool to select patients who are likely to benefit from the treatment. This may help to personalize the treatment in NSCLC patients by avoiding ineffective CCRT and continuing the primary treatment in responding patients
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