Metabolic Burden Measured by 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Is a Prognostic Factor in Patients with Small Cell Lung Cancer
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PurposeEvidence regarding the usefulness of 18F-fluorodeoxyglucose positron emissiontomography/computed tomography (18F-FDG PET/CT) in predicting the prognosis ofnon-small cell lung cancer is increasing. However, data on small cell lung cancer(SCLC) are scarce. The aim of this study was to evaluate the prognostic value of metabolicparameters measured using 18F-FDG PET/CT in patients with SCLC. Materials and MethodsWe conducted a retrospective review of 114 patients with pathologically proven SCLC(26 cases of limited disease and 88 cases of extensive disease) who underwentpretreatment 18F-FDG PET/CT. The maximal SUV (SUVmax) was used quantitatively fordetermination of FDG PET activity. The SUVmax of the primary tumor (primary SUVmax),the sum of SUVmax values of malignant lesions (SUVsum), and the mean SUVmax ofmalignant lesions were calculated. ResultsThe patient population was subdivided using a median SUVsum value of 24.6. HighSUVsum showed a significant association with known factors for poor prognosis,including higher neuron-specific enolase (p=0.010), CYFRA 21-1 (p=0.014), andextensive disease status (p=0.007). Patients with high SUVsum had significantly shortermedian overall survival (6.6 months vs. 13.0 months, p<0.001) and progression-freesurvival (5.2 months vs. 8.0 months, p<0.001) than patients with low SUVsum. Resultsof multivariate analysis showed that SUVsum, chemotherapy cycles, and the responseto first-line treatment were significant prognostic factors of survival. In contrast, meanSUVmax and primary SUVmax were not significant predictors of survival. ConclusionIn this study, metabolic burden represented by SUVsum from pretreatment 18F-FDGPET/CT was an independent prognostic factor in patients with SCLC.
Abstract
PurposeEvidence regarding the usefulness of 18F-fluorodeoxyglucose positron emissiontomography/computed tomography (18F-FDG PET/CT) in predicting the prognosis ofnon-small cell lung cancer is increasing. However, data on small cell lung cancer(SCLC) are scarce. The aim of this study was to evaluate the prognostic value of metabolicparameters measured using 18F-FDG PET/CT in patients with SCLC. Materials and MethodsWe conducted a retrospective review of 114 patients with pathologically proven SCLC(26 cases of limited disease and 88 cases of extensive disease) who underwentpretreatment 18F-FDG PET/CT. The maximal SUV (SUVmax) was used quantitatively fordetermination of FDG PET activity. The SUVmax of the primary tumor (primary SUVmax),the sum of SUVmax values of malignant lesions (SUVsum), and the mean SUVmax ofmalignant lesions were calculated. ResultsThe patient population was subdivided using a median SUVsum value of 24.6. HighSUVsum showed a significant association with known factors for poor prognosis,including higher neuron-specific enolase (p=0.010), CYFRA 21-1 (p=0.014), andextensive disease status (p=0.007). Patients with high SUVsum had significantly shortermedian overall survival (6.6 months vs. 13.0 months, p<0.001) and progression-freesurvival (5.2 months vs. 8.0 months, p<0.001) than patients with low SUVsum. Resultsof multivariate analysis showed that SUVsum, chemotherapy cycles, and the responseto first-line treatment were significant prognostic factors of survival. In contrast, meanSUVmax and primary SUVmax were not significant predictors of survival. ConclusionIn this study, metabolic burden represented by SUVsum from pretreatment 18F-FDGPET/CT was an independent prognostic factor in patients with SCLC.
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