| High rates of tumor growth and disease progression detected on serial pretreatment fluorodeoxyglucose-positron emission tomography/computed tomography scans in radical radiotherapy candidates with nonsmall cell lung cancer. | |
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MedLine Citation:
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PMID: 20623786 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The authors studied growth and progression of untreated nonsmall cell lung cancer (NSCLC) by comparing diagnostic and radiotherapy (RT) planning fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) scans before proposed radical chemo-RT. METHODS: Patients enrolled on a prospective clinical trial were eligible for this analysis if they underwent 2 pretreatment whole body FDG-PET/CT scans, >7 days apart. Scan 1 was performed for diagnosis/disease staging and scan 2 for RT planning. Interscan comparisons included disease stage, metabolic characteristics, tumor doubling times, and change in treatment intent. RESULTS: Eighty-two patients underwent planning PET/CT scans between October 2004 and February 2007. Of these, 28 patients (61% stage III, 18% stage II) had undergone prior staging PET/CT scans. The median interscan period was 24 days (range, 8-176 days). Interscan disease progression (TNM stage) was detected in 11 (39%) patients. The probability of upstaging within 24 days was calculated to be 32% (95% confidence interval [CI], 18%-49%). Treatment intent changed from curative to palliative in 8 (29%) cases, in 7 because of PET. For 17 patients who underwent serial PET/CT scans under standardized conditions, there was a mean relative interscan increase of 19% in tumor maximum standardized uptake value (SUV) (P=.022), 16% in average SUV (P=.004), and 116% in percentage injected dose (P=.002). Estimated doubling time of FDG avid tumor was 66 days (95% CI, 51-95 days). CONCLUSIONS: Rapid tumor progression was detected in patients with untreated, predominantly stage III, NSCLC on serial FDG-PET/CT imaging, highlighting the need for prompt diagnosis, staging, and initiation of therapy in patients who are candidates for potentially curative therapy. |
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Authors:
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Sarah Everitt; Alan Herschtal; Jason Callahan; Nikki Plumridge; David Ball; Tomas Kron; Michal Schneider-Kolsky; David Binns; Rodney J Hicks; Michael MacManus |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Cancer Volume: 116 ISSN: 0008-543X ISO Abbreviation: Cancer Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-10-25 Completed Date: 2010-12-14 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0374236 Medline TA: Cancer Country: United States |
Other Details:
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Languages: eng Pagination: 5030-7 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2010 American Cancer Society. |
Affiliation:
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Department of Radiation Oncology, Radiation Therapy Services, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia. sarah.everitt@petermac.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Carcinoma, Non-Small-Cell Lung / pathology, radiography*, radiotherapy Clinical Trials as Topic Disease Progression Female Fluorodeoxyglucose F18 / diagnostic use Humans Lung Neoplasms / pathology, radiography*, radiotherapy Male Middle Aged Positron-Emission Tomography / methods* |
| Chemical | |
Reg. No./Substance:
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63503-12-8/Fluorodeoxyglucose F18 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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