Prognostic significance of metabolic parameters measured by 18F-FDG PET/CT in limited-stage small-cell lung carcinoma.

Abstract

Metabolic parameters measured by [18F]-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG PET/CT) are important prognostic factors in several types of cancers. We evaluated the predictive value of tumor metabolic parameters measured by 18F-FDG PET/CT in limited-disease small-cell lung cancer (LD-SCLC). This retrospective study included 30 LD-SCLC patients who underwent standard chemotherapy after radiotherapy with 18F-FDG PET/CT. The maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and blood glucose-corrected values were used to evaluate metabolic parameters in primary tumors. For the median follow-up of 41.1 months, median overall survival (OS) was 75.0months [95% confidence interval (CI) 20.9-129.1 months], and median progression-free survival (PFS) was 9.5months (95% CI 6.8-12.1months). Two-year OS was 78.6%, and PFS was 32.7%. OS analysis indicated that MTV and TLG were significant predictors of OS following standard treatment. High glucose-corrected SUVmax (glu-SUVmax) was related to shorter median PFS. On multivariate analysis, MTV was an independent factor of OS, and glu-SUVmax was significantly related to PFS. MTV and glu-SUVmax measured on pretreatment 18F-FDG PET/CT were independent prognostic factors for LD-SCLC patients after chemoradiotherapy with curative intent. These metabolic markers need validation in larger prospective studies but may be useful in the clinical care of LD-SCLC patients.