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. 2022 Mar 30:11:100241.
doi: 10.1016/j.lana.2022.100241. eCollection 2022 Jul.

Applying PET-CT for predicting the efficacy of SBRT to inoperable early-stage lung adenocarcinoma: A Brazilian case-series

Fabio Y Moraes  1   2 , Carlos E C V Abreu  3 , Gabriela S M Siqueira  4 , Cecilia K Haddad  3 , Fabiana A M Degrande  3   5 , Wilma M Hopman  6 , Wellington F P Neves-Junior  3 , Rafael Gadia  4 , Heloisa A Carvalho  1   3   7
Affiliations

Applying PET-CT for predicting the efficacy of SBRT to inoperable early-stage lung adenocarcinoma: A Brazilian case-series

Fabio Y Moraes et al. Lancet Reg Health Am. .

Abstract

Background: Stereotactic body radiotherapy (SBRT) is a treatment option for early-stage inoperable primary lung cancer. Here we report a thorough description of the prognostic value of pre-SBRT SUVmax for predicting the efficacy of SBRT in early-stage lung adenocarcinoma.

Methods: This is a retrospective study of consecutive cases of early-stage inoperable lung adenocarcinoma, staged with PET-CT, treated with SBRT between 2007 and 17. Kaplan-Meier (KM) curves were used to assess overall survival and compare time to event between those with PET-CT SUVmax values ≤ 5.0 and those > 5. Fisher's Exact tests and the Mann-Whitney U were used to compare the patient and clinical data of those with SUVmax≤5.0 and >5.0, and those with and without any failure.

Findings: Amongst 50 lung carcinoma lesions, from 47 patients (34 (68%)-T1a or <T1b), estimated median overall survival from the KM was 44.9 months (95% confidence interval 35.5-54.3). Five experienced a local failure, which was inadequate for detecting differences between those with PET-CT SUVmax ≤5.0 and those >5 (p = 0.112). In addition, 5 experienced a regional failure and 4 a distant failure. Higher PET-CT SUVmax values before SBRT were associated with an increased risk of any failure (36% versus 0%, p = 0.0040 on Fisher's Exact test) and faster time to event (p = 0.010, log rank test). Both acute and late toxicities profile were acceptable.

Interpretation: Patients with early-stage inoperable lung adenocarcinoma present good clinical outcomes when treated with SBRT. We raised the hypothesis that the value of PET-CT SUVmax before SBRT may be an important predictive factor in disease control.

Funding: None.

Keywords: Adeno, Adenocarcinoma; Adenocarcinoma; Lung CA, lung cancer; Lung neoplasms; PET, PET-CT; Positron emission tomography computed tomography; RT, Radiotherapy; Radiosurgery/methods; Radiotherapy; SBRT, Stereotatic body radiotherapy.

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Conflict of interest statement

FYM received honoraria from Astra Zeneca and IASLC outside the submitted work. FYM declares grants or contracts from CTAQ Queen's University outside the current work. FYM has received consulting fees from Cancer em foco outside of the submitted work. All other authors have declared no conflicts of interest.

Figures

Fig 1
Figure 1
Imaging representation of the bronchial tree zone. Bronchial tree zone (light pink) is defined by a 2 cm expansion around the proximal bronchial tree (orange). The Bronchial tree zone was used to define central lesions (inside the light pink zone - green lesions) or peripheral (outside the light pink zone - dark pink lesion).
Fig 2
Figure 2
Overall survival curve for early-stage adenocarcinoma of the lung staged with PET-CT and treated with SBRT.
Fig 3
Figure 3
Kaplan-Meier Curve for time to Failure, comparing SUV_max ≤ 5.0 to those > 5.0.
See this image and copyright information in PMC

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