Predictive value of interim 18F-FDG-PET in patients with non-small cell lung cancer treated with definitive radiation therapy.

PURPOSE: We evaluated that early metabolic response determined by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) during radiotherapy (RT), predicts outcomes in non-small cell lung cancer. MATERIAL AND METHODS: Twenty-eight patients evaluated using pretreatment 18F-FDG-PET/CT (PETpre) and interim 18F-FDG-PET/CT (PETinterim) after 11 fractions of RT were retrospectively reviewed. Maximum standardized uptake value (SUVmax) was calculated for primary lesion. Predictive value of gross tumor volume (ΔGTV) and SUVmax (ΔSUVmax) changes was evaluated for locoregional control (LRC), distant failure (DF), and overall survival (OS). Metabolic responders were patients with ΔSUVmax >40%. RESULTS: Metabolic responders showed better trends in 1-year LRC (90.9%) than non-responders (47.1%) (p = 0.086). Patients with large GTVpre (≥120 cc) demonstrated poor LRC (hazard ratio 4.14, p = 0.022), while metabolic non-responders with small GTVpre (<120 cc) and metabolic responders with large GTVpre both had 1-year LRC rates of 75.0%. Reduction of 25% in GTV was not associated with LRC; however, metabolic responders without a GTV response showed better 1-year LRC (83.3%) than metabolic non-responders with a reduction in GTV (42.9%). Metabolic responders showed lower 1-year DF (16.7%) than non-responders (50.0%) (p = 0.025). An ΔSUVmax threshold of 40% yielded accuracy of 64% for predicting LRC, 75% for DF, and 54% for OS. However, ΔGTV > 25% demonstrated inferior diagnostic values than metabolic response. CONCLUSIONS: Changes in tumor metabolism diagnosed using PETinterim during RT better predicted treatment responses, recurrences, and prognosis than other factors historically used.

Validation study of the Korean version of the McGill Quality of Life Questionnaire.

This study aimed to test the reliability and validity of the Korean version of McGill Quality of Life Questionnaire (MQOL-K) for use with 140 palliative care patients in Korea. Our results confirmed the suitability of using the 16 questions of the questionnaire clustered into four domains (physical, psychological, existential and support) as in the original version of the MQOL, although the distribution of items among the domains differed somewhat from the original. The MQOL-K demonstrated moderate to high internal consistency (Cronbach's alpha, 0.62-0.90), convergent validity without scaling error, and a good concurrent validity with European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, sense of dignity, and general health perception. In addition, we tested the clinical validity of the MQOL-K using a known group comparison to quantify sensitivity. Regression results indicated that the existential and psychological domains had independent effects on the overall quality of life of patients in Korea. Therefore, the MQOL-K is deemed suitable for assessing the quality of life in a Korean palliative care setting.