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S. Mathur
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P3.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 214)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Locoregional Disease – NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.03-024 - Efficacy of 18 F-FDG PET/CT as Response Predictor in Locally Advanced Non-Small Cell Lung Cancer (ID 442)
09:30 - 09:30 | Author(s): S. Mathur
- Abstract
Background:
The study was aimed to assess the role of [18]F-FDG PET/CT in response assessment of patients with locally advanced non-small cell lung cancer (NSCLC) and in evaluating the predictive value of metabolic response for progression-free survival (PFS) and overall survival (OS).
Methods:
Thirty patients of locally advanced NSCLC were enrolled in this randomized controlled study and were allocated to one of the two treatment arms. Patients in Arm A (n=15) received neoadjuvant chemotherapy (NACT) and external beam radiotherapy (EBRT) while arm B (n=15) received NACT and EBRT with concomitant chemotherapy. [18]F-FDG PET/CT was carried out at baseline and after 6-weeks of completion of intended treatment. Pre and post-treatment maximum standardized uptake value (SUVmax) was noted. A reduction of SUVmax> 50% (∆SUVmax) were considered to be metabolic responders (MR) and ≤ 50% as non-responders (MNR). The difference in SUVmax parameters were compared by Wilcoxon signed rank test and Mann-Whitney U test for paired and unpaired samples. The significance of difference in the number of MR and MNR between two arms was computed using Fisher’s exact test. Survival time was estimated by Kaplan–Meier survival analysis. Survival pattern was compared using the log-rank test. Factors which had p value <0.25 in univariate analysis were subjected to multivariate analysis using Cox regression analysis. Statistical analysis was carried out using Stata software version 12.0.
Results:
Twenty one patients completed the intended treatment. The median pre and post-treatment SUVmax were 14, 6.4 for arm A and 15.3, 3.5 for arm B. There was no statistically significant difference between pre and post treatment SUVmax among the two treatment arms. Significant decrease in SUVmax was observed in both arms (median ∆SUVmax of 50% and 74% in arm A and B; p=0.618). Twelve patients achieved metabolic response. Metabolic response rate in arm A and B was 50% and 64% respectively (p=0.783). At median follow-up of 18.98 months the median PFS and OS of the MR were 22.31, 24.73 months and of MNR were 7.83, 8.26 months The Cox proportional hazard ratio for PFS and OS in MNR group was 2.33 (95% confidence interval i.e. C.I: 0.78-6.91) and 2.12 (95% C.I: 0.65-6.97). No significant difference in OS and PFS was observed between MR and MNR subpopulation of two arms (table-1).Group Median PFS (in months) P value (Log rank test) Median OS (in months) P value (Log rank test) Total cohort: 17.02 (95% C.I:7.44-22.31) - 24.73 - MR: MNR: 22.31 7.83 0.09 24.73 8.26 0.12 Arm A Arm B 18.7 9.12 0.59 24.73 15.4 0.27 MR of Arm A MR of arm B 10.5 22.3 0.34 15.4 Not achieved 0.27 MNR of arm A MNR of Arm B 7.44 7.83 0.71 7.47 8.26 0.71
Conclusion:
PET/CT distinguishes responders to treatment based on metabolic activity in patients with locally advanced NSCLC, but did not provide any prognostic significance.
