Early PET/CT scans for assessing treatment responses of non-small cell lung cancer for SBRT boost: what to do with scans from multiple scanners.
J Radiosurg SBRT
; 2(4): 315-323, 2013.
Article
em En
| MEDLINE
| ID: mdl-29296374
ABSTRACT
Chemoradiation remains the standard of care for the nonsurgical treatment of advanced non-small cell lung cancer (NSCLC) but local recurrence rates of 30-40% are documented. We examined the early PET/CT responses of NSCLC treated with standard chemoradiation in a prospective single institutional trial of early 18F-2-deoxy-D-glucose-PET/CT scans to help define patients appropriate for dose escalation with SBRT. 48 patients with stage IIA, IIB or IIIA-B NSCLC with no or non-bulky (= 3.0 cm) lymphadenopathy were included. Approximately one month following chemoradiation, PET-CT was performed to assess responses. Since many patients came from outside facilities, the ability to directly compare pre- and post therapy PET/CT SUV values is compromised. Thus, patients had their pre- and post-chemoradiation PET/CT SUV's assessed where possible, but also reviewed in a blinded manner by two experienced nuclear medicine physicians who scored the results on a subjective scale of FDG uptake to assess treatment responses. A high level of agreement was found between the reading nuclear medicine physicians 0.76 (95% CI of 0.6 to 0.92). Disease progression occurred in 16% of scans including new metastatic or regional failures. 77% of patients had significant improvement in FDG uptake in the primary tumor but only 4.2% had complete resolution. Mediastinal adenopathy had resolved or significantly improved in 90%. This good, but not complete reduction of FDG uptake in the primary tumor suggests that it may be an appropriate target for local intensified radiation boost.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Idioma:
En
Revista:
J Radiosurg SBRT
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Estados Unidos