Abstract:

Background and purpose: We investigated whether fluorine-18 fluorodeoxyglucose (¹⁸F-FDG) maximal standard uptake value (SUV_max) of the primary tumor (SUV-T), SUV_max of the regional lymph nodes (SUV-N) or the overall loco-regional lesion SUV_max (SUV-TOTAL) was related to survival of patients with stage Ⅲ nonsmall cell lung cancer (NSCLC) who received Cetuximab and combined definitive chemoradiotherpay. Methods: From September 2009 to July 2012, seventeen patients with unresectable stage Ⅲ NSCLC receiving cetuximab with cisplatin/vinorelbine (NP) followed by concomitant NP and intensity-modulated radiotherapy (IMRT) at the Fudan University Shanghai Cancer Center were enrolled onto a prospectively study. All patients received positron emission tomography/computerized tomography (PET/CT) scans within 2 weeks before enrolment. Univariate analysis were used to assess the correlation between SUV-T, SUV-N, SUV-TOTAL, gender, age, histology, tumour-node-metastasis (TNM) stage, performance status (PS) as well as smoking status and survival. The factors which showed statistical significance entered into multivariate Cox-regression model. Survival functions of different populations were estimated by Kaplan-Meier method and compared by Log-rank test. Results: In the univariate analysis, SUV-T, SUV-N, SUVTOTAL, PS and smoking status were prognostic factors. The best cut-off values for SUV-T, SUV-N and SUV-TOTAL were 11, 11 and 20, respectively. Multivariate analysis revealed that SUV-TOTAL (P=0.012), SUV-T (P=0.025), and SUV-N (P=0.033) were independent predictors of survival with hazard ratio (HR) of 14.7, 11.2, and 6.2, respectively. Conclusion: Local, regional and locoregional maximal SUVs defined by 18F-FDG PET-CT scanning may have a strong correlation with survival in this patients setting, which merits further study.

Key words: Non-small cell lung cancer, PET/CT, Standardized uptake values, Prognosis