Author of

• 11794

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  P2.12 - Poster Session 2 - NSCLC Early Stage (ID 205)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Medical Oncology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11805

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    P2.12-011 - Pre-Radiotherapy PET SUV Maximum Predicts for Overall Survival in Patients with Early-Stage NSCLC Treated with Stereotactic Body Radiation Therapy (ID 1583)

    09:30 - 09:30  |  Author(s): R.H. Decker
    • Abstract

    Background
    The prognostic importance of positron emission tomography (PET) standardized uptake value maximum (SUVm) scores for patients with early stage non-small cell lung carcinoma (ES-NSCLC) treated with stereotactic body radiotherapy (SBRT) is unclear. This study aims to address this uncertainty.

    Methods
    Records of patients diagnosed with ES-NSCLC and treated with SBRT between September 2007 and May 2012 were retrospectively reviewed. Mediastinoscopy was used to stage patients with synchronous primary lesions, centrally located lesions, and those larger than 3 cm. SBRT was delivered via 3-5 fractions to a dose of 40-60 Gy, with the vast majority of patients receiving 54 Gy in 3 fractions. Univariate and multivariate Cox proportional hazards analyses were used to compare disease progression and overall survival on the basis of pre- and post-SBRT SUVm, absolute change in SUVm, age, tumor size, and histology.

    Results
    127 patients with a median follow-up of 14 months were identified. Median age was 73.9 years and 54% were male. Histology was adenocarcinoma in 39%, squamous cell carcinoma in 20%, unspecified NSCLC in 20%, and unbiopsied in 21%. Pre-SBRT PET was available in 98% and median pre-SBRT SUVm was 4.8. Post-SBRT PET was performed in 33% and median post-SBRT SUVm was 2.3. SUVm declined by a median of 3.7 units post-SBRT. There were 5, 4, and 12 local, regional, and distant failures, respectively. On multivariate analysis, older age, tumor size, and squamous histology predicted for higher rates of any failure (p=0.034, <0.001, 0.016, respectively). Conversely, larger absolute reduction in SUVm post-SBRT predicted for improved rates of disease control (p=0.005). Median OS was 14.65 months. On multivariate Cox proportional hazards analysis of predictors of overall survival, higher pre-SBRT SUVm, larger size, squamous cell histology, and staging mediastinoscopy predicted for worse OS (all p<0.05).

    Conclusion
    PET is a powerful tool in the work-up of newly diagnosed NSCLC. SUVm values appear to also have prognostic importance, as absolute change in SUVm after SBRT predicts for failure and pre-SBRT SUVm predicts for overall survival.