Pierre Vera, Philippe Giraud, Sébastien Hapdey, Pierrick Gouel, Orianne Jan, Paul Le Roux, Alexandra Langlais, Emilie Lévêque, Florence Le Tinier, Anaïs Olivier, Etienne Martin, Alina Berriolo-Riedinger, Nicolas Pourel, Jean Marc Broglia, Pierre Boisselier, Sophie Guillemard, Naji Salem, Isabelle Brenot-Rossi, Camilo Garcia, Céline Berthold, Etienne Giroux-Leprieur, Damien Moreau, Sophie Guillerm, Khadija Benali, Laurent Tessonnier, Clarisse Audigier-Valette, Delphine Lerouge, Elske Quak, Carole Massabeau, Frédéric Courbon, Maxime Loo, Anne Larrouy, Nadia Ghazzar, Philippe Chaumet-Riffaud, Elodie Amour, Gérard Zalcman, Romain Modzelewski, Sébastien Thureau
{"title":"42 Gy放化疗前后FDG - PET代谢参数对不能手术III期非小细胞肺癌患者的预后价值","authors":"Pierre Vera, Philippe Giraud, Sébastien Hapdey, Pierrick Gouel, Orianne Jan, Paul Le Roux, Alexandra Langlais, Emilie Lévêque, Florence Le Tinier, Anaïs Olivier, Etienne Martin, Alina Berriolo-Riedinger, Nicolas Pourel, Jean Marc Broglia, Pierre Boisselier, Sophie Guillemard, Naji Salem, Isabelle Brenot-Rossi, Camilo Garcia, Céline Berthold, Etienne Giroux-Leprieur, Damien Moreau, Sophie Guillerm, Khadija Benali, Laurent Tessonnier, Clarisse Audigier-Valette, Delphine Lerouge, Elske Quak, Carole Massabeau, Frédéric Courbon, Maxime Loo, Anne Larrouy, Nadia Ghazzar, Philippe Chaumet-Riffaud, Elodie Amour, Gérard Zalcman, Romain Modzelewski, Sébastien Thureau","doi":"10.2967/jnumed.124.268499","DOIUrl":null,"url":null,"abstract":"<p>The purpose of this study was to assess the prognostic value of <sup>18</sup>F-FDG PET parameter variation between baseline and 42 Gy (PET2) of radiochemotherapy at 6 mo and 1 y of evaluation in patients with stage III inoperable nonsmall cell lung cancer based on RECIST 1.1. <strong>Methods:</strong> In total, 158 patients in a prospective multicenter phase II/III study were analyzed. Patients were randomized into 2 groups: an experimental arm (group A) and a standard arm (group B). Patients from group A with residual metabolism on PET2 (group A+) at 42 Gy received a radiation boost (74 Gy). Patients without residual uptake on <sup>18</sup>F-FDG PET at 42 Gy (group A−) and patients in group B received a standard radiotherapy dose (66 Gy). We compared group A with group B. The <sup>18</sup>F-FDG PET parameters SUV<sub>max</sub>, SUV<sub>mean</sub>, SUV<sub>peak</sub>, peak SUV normalized on lean body mass, mean SUV normalized on lean body mass, total lesion glycolysis, total metabolic tumor volume (MTV) (tumor and nodes), and tumor MTV were measured. All patients were evaluated with RECIST 1.1 using CT at 6 mo and 1 y after radiochemotherapy. Progression-free survival and overall survival were evaluated. <strong>Results:</strong> Except for the radiotherapy dose (<em>P</em> < 0.001), patient demographic characteristics were similar between the 2 groups (A vs. B). All <sup>18</sup>F-FDG PET uptake and volume parameter measurements were correlated. Therefore, only the change in SUV<sub>max</sub> (ΔSUV<sub>max</sub>) and total MTV were selected for the analysis. There was no significant difference in any variable between the 2 groups. In the multivariate analysis, ΔSUV<sub>max</sub> appeared to be the most important prognostic factor for overall survival, and SUV<sub>max</sub> of PET2 appeared to be the most important prognostic factor for progression-free survival. <strong>Conclusion:</strong> <sup>18</sup>F-FDG PET at 42 Gy can be used to identify good responders to radiochemotherapy in patients with inoperable stage III nonsmall cell lung cancer. The SUV<sub>max</sub> of PET2 and ΔSUV<sub>max</sub> are independent prognostic factors.</p>","PeriodicalId":22820,"journal":{"name":"The Journal of Nuclear Medicine","volume":"9 12 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prognostic Value of FDG PET Metabolic Parameters Before and After 42 Gy of Radiochemotherapy in Patients with Inoperable Stage III Nonsmall Cell Lung Cancer\",\"authors\":\"Pierre Vera, Philippe Giraud, Sébastien Hapdey, Pierrick Gouel, Orianne Jan, Paul Le Roux, Alexandra Langlais, Emilie Lévêque, Florence Le Tinier, Anaïs Olivier, Etienne Martin, Alina Berriolo-Riedinger, Nicolas Pourel, Jean Marc Broglia, Pierre Boisselier, Sophie Guillemard, Naji Salem, Isabelle Brenot-Rossi, Camilo Garcia, Céline Berthold, Etienne Giroux-Leprieur, Damien Moreau, Sophie Guillerm, Khadija Benali, Laurent Tessonnier, Clarisse Audigier-Valette, Delphine Lerouge, Elske Quak, Carole Massabeau, Frédéric Courbon, Maxime Loo, Anne Larrouy, Nadia Ghazzar, Philippe Chaumet-Riffaud, Elodie Amour, Gérard Zalcman, Romain Modzelewski, Sébastien Thureau\",\"doi\":\"10.2967/jnumed.124.268499\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>The purpose of this study was to assess the prognostic value of <sup>18</sup>F-FDG PET parameter variation between baseline and 42 Gy (PET2) of radiochemotherapy at 6 mo and 1 y of evaluation in patients with stage III inoperable nonsmall cell lung cancer based on RECIST 1.1. <strong>Methods:</strong> In total, 158 patients in a prospective multicenter phase II/III study were analyzed. Patients were randomized into 2 groups: an experimental arm (group A) and a standard arm (group B). Patients from group A with residual metabolism on PET2 (group A+) at 42 Gy received a radiation boost (74 Gy). Patients without residual uptake on <sup>18</sup>F-FDG PET at 42 Gy (group A−) and patients in group B received a standard radiotherapy dose (66 Gy). We compared group A with group B. The <sup>18</sup>F-FDG PET parameters SUV<sub>max</sub>, SUV<sub>mean</sub>, SUV<sub>peak</sub>, peak SUV normalized on lean body mass, mean SUV normalized on lean body mass, total lesion glycolysis, total metabolic tumor volume (MTV) (tumor and nodes), and tumor MTV were measured. All patients were evaluated with RECIST 1.1 using CT at 6 mo and 1 y after radiochemotherapy. Progression-free survival and overall survival were evaluated. <strong>Results:</strong> Except for the radiotherapy dose (<em>P</em> < 0.001), patient demographic characteristics were similar between the 2 groups (A vs. B). All <sup>18</sup>F-FDG PET uptake and volume parameter measurements were correlated. Therefore, only the change in SUV<sub>max</sub> (ΔSUV<sub>max</sub>) and total MTV were selected for the analysis. There was no significant difference in any variable between the 2 groups. In the multivariate analysis, ΔSUV<sub>max</sub> appeared to be the most important prognostic factor for overall survival, and SUV<sub>max</sub> of PET2 appeared to be the most important prognostic factor for progression-free survival. <strong>Conclusion:</strong> <sup>18</sup>F-FDG PET at 42 Gy can be used to identify good responders to radiochemotherapy in patients with inoperable stage III nonsmall cell lung cancer. The SUV<sub>max</sub> of PET2 and ΔSUV<sub>max</sub> are independent prognostic factors.</p>\",\"PeriodicalId\":22820,\"journal\":{\"name\":\"The Journal of Nuclear Medicine\",\"volume\":\"9 12 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-02-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The Journal of Nuclear Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2967/jnumed.124.268499\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Journal of Nuclear Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2967/jnumed.124.268499","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Prognostic Value of FDG PET Metabolic Parameters Before and After 42 Gy of Radiochemotherapy in Patients with Inoperable Stage III Nonsmall Cell Lung Cancer
The purpose of this study was to assess the prognostic value of 18F-FDG PET parameter variation between baseline and 42 Gy (PET2) of radiochemotherapy at 6 mo and 1 y of evaluation in patients with stage III inoperable nonsmall cell lung cancer based on RECIST 1.1. Methods: In total, 158 patients in a prospective multicenter phase II/III study were analyzed. Patients were randomized into 2 groups: an experimental arm (group A) and a standard arm (group B). Patients from group A with residual metabolism on PET2 (group A+) at 42 Gy received a radiation boost (74 Gy). Patients without residual uptake on 18F-FDG PET at 42 Gy (group A−) and patients in group B received a standard radiotherapy dose (66 Gy). We compared group A with group B. The 18F-FDG PET parameters SUVmax, SUVmean, SUVpeak, peak SUV normalized on lean body mass, mean SUV normalized on lean body mass, total lesion glycolysis, total metabolic tumor volume (MTV) (tumor and nodes), and tumor MTV were measured. All patients were evaluated with RECIST 1.1 using CT at 6 mo and 1 y after radiochemotherapy. Progression-free survival and overall survival were evaluated. Results: Except for the radiotherapy dose (P < 0.001), patient demographic characteristics were similar between the 2 groups (A vs. B). All 18F-FDG PET uptake and volume parameter measurements were correlated. Therefore, only the change in SUVmax (ΔSUVmax) and total MTV were selected for the analysis. There was no significant difference in any variable between the 2 groups. In the multivariate analysis, ΔSUVmax appeared to be the most important prognostic factor for overall survival, and SUVmax of PET2 appeared to be the most important prognostic factor for progression-free survival. Conclusion:18F-FDG PET at 42 Gy can be used to identify good responders to radiochemotherapy in patients with inoperable stage III nonsmall cell lung cancer. The SUVmax of PET2 and ΔSUVmax are independent prognostic factors.
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