Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2013 Oct 20;31(30):3823-30.
doi: 10.1200/JCO.2012.47.5947. Epub 2013 Sep 16.

Prediction of survival by [18F]fluorodeoxyglucose positron emission tomography in patients with locally advanced non-small-cell lung cancer undergoing definitive chemoradiation therapy: results of the ACRIN 6668/RTOG 0235 trial

Mitchell Machtay  1 , Fenghai Duan, Barry A Siegel, Bradley S Snyder, Jeremy J Gorelick, Janet S Reddin, Reginald Munden, Douglas W Johnson, Larry H Wilf, Albert DeNittis, Nancy Sherwin, Kwan Ho Cho, Seok-Ki Kim, Gregory Videtic, Donald R Neumann, Ritsuko Komaki, Homer Macapinlac, Jeffrey D Bradley, Abass Alavi
Affiliations
Clinical Trial

Prediction of survival by [18F]fluorodeoxyglucose positron emission tomography in patients with locally advanced non-small-cell lung cancer undergoing definitive chemoradiation therapy: results of the ACRIN 6668/RTOG 0235 trial

Mitchell Machtay et al. J Clin Oncol. .

Abstract

Purpose: In this prospective National Cancer Institute-funded American College of Radiology Imaging Network/Radiation Therapy Oncology Group cooperative group trial, we hypothesized that standardized uptake value (SUV) on post-treatment [(18)F]fluorodeoxyglucose positron emission tomography (FDG-PET) correlates with survival in stage III non-small-cell lung cancer (NSCLC).

Patients and methods: Patients received conventional concurrent platinum-based chemoradiotherapy without surgery; postradiotherapy consolidation chemotherapy was allowed. Post-treatment FDG-PET was performed at approximately 14 weeks after radiotherapy. SUVs were analyzed both as peak SUV (SUVpeak) and maximum SUV (SUVmax; both institutional and central review readings), with institutional SUVpeak as the primary end point. Relationships between the continuous and categorical (cutoff) SUVs and survival were analyzed using Cox proportional hazards multivariate models.

Results: Of 250 enrolled patients (226 were evaluable for pretreatment SUV), 173 patients were evaluable for post-treatment SUV analyses. The 2-year survival rate for the entire population was 42.5%. Pretreatment SUVpeak and SUVmax (mean, 10.3 and 13.1, respectively) were not associated with survival. Mean post-treatment SUVpeak and SUVmax were 3.2 and 4.0, respectively. Post-treatment SUVpeak was associated with survival in a continuous variable model (hazard ratio, 1.087; 95% CI, 1.014 to 1.166; P = .020). When analyzed as a prespecified binary value (≤ v > 3.5), there was no association with survival. However, in exploratory analyses, significant results for survival were found using an SUVpeak cutoff of 5.0 (P = .041) or 7.0 (P < .001). All results were similar when SUVmax was used in univariate and multivariate models in place of SUVpeak.

Conclusion: Higher post-treatment tumor SUV (SUVpeak or SUVmax) is associated with worse survival in stage III NSCLC, although a clear cutoff value for routine clinical use as a prognostic factor is uncertain at this time.

PubMed Disclaimer

Conflict of interest statement

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

Figures

Fig 1.
Fig 1.
Scatter plots demonstrating institutional versus central read results for standardized uptake value (SUV) within the primary lung tumor. Pretreatment (A) peak SUV (SUVpeak) and (B) maximum SUV (SUVmax). Post-treatment (C) SUVpeak and (D) SUVmax. CCC, concordance correlation coefficient; Mean diff, mean difference between institutional SUV and central SUV.
Fig 2.
Fig 2.
Overall survival as a function of post-treatment peak standardized uptake value (SUV; ≤ v > 3.5). The results are not statistically significantly different. PET, positron emission tomography.
Fig 3.
Fig 3.
Overall survival based on a peak standardized uptake value (SUV) cutoff of 5.0. (A) Results based on local institutional read. (B) Results based on central review read. PET, positron emission tomography.
See this image and copyright information in PMC

Comment in

References

    1. Goldstraw P, Ball D, Jett JR, et al. Non-small-cell lung cancer. Lancet. 2011;378:1727–1740. - PubMed
    1. Hanna N, Neubauer M, Yiannoutsos C, et al. Phase III study of cisplatin, etoposide and concurrent chest radiation with or without consolidation docetaxel in patients with inoperable stage III non-small cell lung cancer: The Hoosier Oncology Group and U.S. Oncology. J Clin Oncol. 2008;26:5755–5760. - PubMed
    1. Yamamoto N, Nakagawa K, Nishimura Y, et al. Phase III study comparing second- and third-generation regimens with concurrent thoracic radiotherapy in patients with unresectable stage III non-small-cell lung cancer: West Japan Thoracic Oncology Group WJTOG0105. J Clin Oncol. 2010;28:3739–3745. - PubMed
    1. Le Chevalier T, Arriagada R, Quoix E, et al. Radiotherapy alone versus combined chemotherapy and radiotherapy in unresectable non-small cell lung carcinoma. Lung Cancer. 1994;10(suppl 1):S239–S244. - PubMed
    1. Mac Manus MP, Hicks RJ, Matthews JP, et al. Positron emission tomography is superior to computed tomography scanning for response-assessment after radical radiotherapy or chemoradiotherapy in patients with non-small-cell lung cancer. J Clin Oncol. 2003;21:1285–1292. - PubMed

Publication types

MeSH terms