Metabolic response assessment with 18F-FDG PET-CT: inter-method comparison and prognostic significance for patients with non-small cell lung cancerReportar como inadecuado




Metabolic response assessment with 18F-FDG PET-CT: inter-method comparison and prognostic significance for patients with non-small cell lung cancer - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Journal of Radiation Oncology

, Volume 4, Issue 3, pp 249–256

First Online: 12 March 2015Received: 18 December 2014Accepted: 29 January 2015DOI: 10.1007-s13566-015-0184-9

Cite this article as: Wang, J., Wong, K.K., Piert, M. et al. J Radiat Oncol 2015 4: 249. doi:10.1007-s13566-015-0184-9

Abstract

ObjectiveThis study aimed to 1 compare the agreement of two evaluation methods of metabolic response in patients with non-small cell lung cancer NSCLC and determine their prognostic value and 2 explore an optimal cutoff of metabolic reduction to distinguish a more favorable subset of responders.

MethodsThis is a secondary analysis of prospective studies. Enrolled patients underwent 18F-PET-CT within 2 weeks before, during, and months after radiotherapy post-RT. Metabolic response was assessed using both Peter MacCallum PM method of qualitative visual assessment and University of Michigan UM method of semiquantitative measurement. The agreement between two methods determined response, and their prediction of outcome was analyzed.

ResultsForty-four patients with median follow-up of 25.2 months were analyzed. A moderate agreement was observed between PM- and UM-based response assessment Kappa coefficient = 0.434, unveiling a significant difference in CMR rate p = 0.001. Categorical responses derived from either method were significantly predictive of overall survival OS and progression-free survival PFS p < 0.0001. Numerical percentage decrease of FDG uptake also showed significant correlations with survival, presenting a hazard ratio of 0.97 for both OS and PFS. A 75 % of SUV decrease was found to be the optimal cutoff to predict OS and 2-year progression.

ConclusionsThere was a modest discrepancy in metabolic response rates between PM and UM criteria, though both could offer predictive classification for survival. The percentage decrease provides an ordinal value that correlates with prolonged survival, recommending 75 % as the optimal threshold at identifying better responders.

KeywordsPET-CT Non-small cell lung cancer Metabolic response Overall survival Progression-free survival  Download fulltext PDF



Autor: Jingbo Wang - Ka Kit Wong - Morand Piert - Paul Stanton - Kirk A Frey - Feng-Ming Spring Kong

Fuente: https://link.springer.com/







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