1216P - Efficacy of PET-CT in evaluation of response in locally advanced non-small cell lung cancer

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Non-Small-Cell Lung Cancer, Locally Advanced
Imaging, Diagnosis and Staging
Presenter Soumyajit Roy
Citation Annals of Oncology (2014) 25 (suppl_4): iv417-iv425. 10.1093/annonc/mdu348
Authors S. Roy1, S. Pathy1, R. Kumar2, B.K. Mohanti1, V. Raina3, A. Jaiswal4, A. Malhotra2, S. Thulkar5, A. Mohan6, S. Mathur7, D. Behera8
  • 1Radiotherapy, All India Institute of Medical Sciences, 110029 - New Delhi/IN
  • 2Nuclear Medicine, All India Institute of Medical Sciences, 110029 - New Delhi/IN
  • 3Dept. Of Medical Oncology, All India Institute of Medical Sciences, 110029 - New Delhi/IN
  • 4Pulmonology, LRS Institute of Tuberculosis and Respiratory Diseases, New Delhi/IN
  • 5Radiology, All India Institute of Medical Sciences, 110029 - New Delhi/IN
  • 6Pulmonology, All India Institute of Medical Sciences, 110029 - New Delhi/IN
  • 7Pathology, All India Institute of Medical Sciences, 110029 - New Delhi/IN
  • 8Pulmonary Medicine, LRS Institute of TB and Respiratory Diseases, IN-110030 - New Delhi/IN

Abstract

Aim

Computed tomography (CT) scan, despite its limitation of imaging sequence, is the standard tool for response assessment following chemo-radiation in locally advanced non-small cell lung cancer (LA-NSCLC). Molecular imaging can characterise the temporal nature of biological activity of a tumour. Thus PET (positron emission tomography)-based response evaluation may be useful and provide information for the planning of an optimal therapeutic strategy. This study aimed to assess the role of 18F-fluoro-deoxyglucose PET-CT (18-FDG PET-CT) in response assessment of patients with LA-NSCLC and in evaluating the predictive value of metabolic response for progression-free survival (PFS) and overall survival (OS).

Methods

Between January 2012 and July 2013, 30 patients with LA-NSCLC fulfilling the inclusion criteria were enrolled in this randomized controlled study. All of them were randomly allocated to one of the two treatment arms. Arm A received two cycles of neoadjuvant chemotherapy (NACT) (paclitaxel 200mg/m2 and carboplatin AUC 5) followed by ( f/b) external radiotherapy (XRT) (60Gy/30fractions/6weeks) while arm B received the same NACT regimen f/b XRT (48Gy/20fractions/4weeks), with concurrent chemotherapy (cisplatin 30mg/m2weekly). 18-FDG PET-CT was carried out for all patients before treatment and repeated 6 weeks after completion of treatment. SUVm (maximum standard uptake value) was noted from both the baseline and post-treatment scans. Patients with reduction of SUVm of > 50% were considered to be metabolic responders (MR) while ≤ 50% were considered to be non-responders (MNR). Median follow up duration was 9 months.

Results

The median pre- and post- treatment SUVm were 14.4, 6.24, 15.3 and 3.5 for arm A and arm B, respectively. No statistically significant difference was found in the 1-year estimated OS and PFS rate of MR vs. MNR group though they were numerically superior in the MR-subset.

Parameters at 1 year MR MNR Hazard ratio 95% Confidence interval
PFS 57.14% 42.86% 2.04 0.54-7.66
OS 90.9% 57.14% 1.91 0.32-11.4

Conclusions

The current study fails to derive any prognostic significance of FDG-PET-CT in LA-NSCLC patients. A larger patient sample and longer follow-up might have showed a different result.

Disclosure

All authors have declared no conflicts of interest.