PMID- 22402822
OWN - NLM
STAT- MEDLINE
DCOM- 20120906
LR  - 20120523
IS  - 1824-4785 (Print)
IS  - 1824-4785 (Linking)
VI  - 56
IP  - 2
DP  - 2012 Apr
TI  - The impact of PET and PET/CT on treatment planning and prognosis of patients with 
      NSCLC treated with radiation therapy.
PG  - 191-201
AB  - AIM: 18F fluoro-deoxy-glucose (FDG) positron emission tomography (PET)-imaging 
      improves the diagnostic accuracy in staging non small cell lung cancer (NSCLC) 
      with possible impact on survival. This prospective study aimed to investigate the 
      impact of PET and PET/CT on treatment planning and prognosis in patients with 
      NSCLC treated with radiation therapy. METHODS: From October 2003 to January 2008, 
      91 consecutive patients with proven NSCLC stage T1-4N0-3M0 (clinical stages: 
      I-IIIb) underwent accelerated, twice daily radiation therapy in target splitting 
      technique. 70 patients received chemotherapy before radiation therapy (76%). All 
      patients underwent PET or PET/CT-imaging and were followed up for a median time 
      of 30 months. Imaging findings were interpreted visually and a SUV cut-off of 2.5 
      was applied for delineation of tumor borders. Changes in staging and planning 
      treatment volumes (PTV) due to PET or PET/CT-imaging and survival were defined as 
      primary study endpoints. The impact of tumor-type, stage, age, gender, weight 
      loss and FDG-uptake in PET imaging as measured by the standardized uptake value 
      (SUV) on survival were analysed as secondary endpoints. RESULTS: PET imaging 
      provided additional diagnostic information over CT alone in 20% (N.=18) of our 
      study population, leading to upstaging in 17% of them, respectively. In 5 
      patients (5.5% of 91) atelectasis could be separated from tumor tissue, PTV was 
      altered in 9% (N.=8). 39 patients (43%) died during the observation period, mean 
      overall survival was 32.3 months (95% Confidence intervalI 27.6-37.1) and tumor 
      specific survival was 36.9 months (95 % CI 32.0-42.0), respectively. One- and two 
      year survival rates reached 90.1% and 67.7%, respectively. Multivariate analysis 
      did not reveal any significant prognostic impact of tumor-type, stage, age, 
      gender or FDG-uptake as given by SUVmax (mean 13.6+/-6.8) or SUVmean (mean 
      5.5+/-1.6). CONCLUSION: The use of FDG-PET- and PET/CT-imaging provided incremental 
      information relevant for treatment-planning in about 10 % of patients with NSCLC 
      undergoing accelerated radiation therapy with curative intent. This prospective 
      trial did not provide evidence for the assumption that the SUV might be an 
      independent predictor of outcome.
FAU - Nawara, C
AU  - Nawara C
AD  - Department of Nuclear Medicine and Endocrinology, Paracelsus Medical University, 
      Salzburg, Austria.
FAU - Rendl, G
AU  - Rendl G
FAU - Wurstbauer, K
AU  - Wurstbauer K
FAU - Lackner, B
AU  - Lackner B
FAU - Rettenbacher, L
AU  - Rettenbacher L
FAU - Datz, L
AU  - Datz L
FAU - Studnicka, M
AU  - Studnicka M
FAU - Sedlmayer, F
AU  - Sedlmayer F
FAU - Pirich, C
AU  - Pirich C
LA  - eng
PT  - Controlled Clinical Trial
PT  - Journal Article
DEP - 20120309
PL  - Italy
TA  - Q J Nucl Med Mol Imaging
JT  - The quarterly journal of nuclear medicine and molecular imaging : official 
      publication of the Italian Association of Nuclear Medicine (AIMN) [and] the 
      International Association of Radiopharmacology (IAR), [and] Section of the 
      Society of...
JID - 101213861
SB  - IM
MH  - Aged
MH  - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
MH  - Carcinoma, Non-Small-Cell Lung/*diagnosis/drug therapy/*radiotherapy
MH  - Chemoradiotherapy
MH  - Female
MH  - Humans
MH  - Lung Neoplasms/*diagnosis/drug therapy/*radiotherapy
MH  - Male
MH  - Positron-Emission Tomography/*methods
MH  - Prognosis
MH  - Radiotherapy Dosage
MH  - Radiotherapy Planning, Computer-Assisted/methods
MH  - Radiotherapy, Image-Guided/*methods
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
MH  - Subtraction Technique
MH  - Tomography, X-Ray Computed/*methods
MH  - Treatment Outcome
EDAT- 2012/03/10 06:00
MHDA- 2012/09/07 06:00
CRDT- 2012/03/10 06:00
PHST- 2012/03/10 06:00 [entrez]
PHST- 2012/03/10 06:00 [pubmed]
PHST- 2012/09/07 06:00 [medline]
AID - R39122184 [pii]
PST - ppublish
SO  - Q J Nucl Med Mol Imaging. 2012 Apr;56(2):191-201. Epub 2012 Mar 9.