Document Detail


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.
MedLine Citation:
PMID:  20623786     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article    
Journal Detail:
Title:  Cancer     Volume:  116     ISSN:  0008-543X     ISO Abbreviation:  Cancer     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-25     Completed Date:  2010-12-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  5030-7     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 American Cancer Society.
Affiliation:
Department of Radiation Oncology, Radiation Therapy Services, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia. sarah.everitt@petermac.org
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MeSH Terms
Descriptor/Qualifier:
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:
63503-12-8/Fluorodeoxyglucose F18

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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