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S. McArthur
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P2.02 - Poster Session with Presenters Present (ID 462)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Locally Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.02-047 - Association of FDG PET, Complete Pathological Response and Overall Survival in Patients with Pancoast Tumours Treated with Trimodality Therapy (ID 5331)
14:30 - 14:30 | Author(s): S. McArthur
- Abstract
Background:
Induction chermoradiotherapy (CRT) and surgical resection is considered standard care for treatment of node negative Pancoast tumours. However, not all patients benefit from this approach and there are no well-defined preoperative parameters to identify patients for whom addition of surgery may be unnecessary due to local control with CRT alone. We investigated wether baseline FDG positron emission tomography (PET) scan parameters or changes post induction may predict complete pathological response (pCR) to CRT and hence obviate the need for subsequent resection.
Methods:
We conducted a retrospective review of our prospectively maintained single institution database with supplemental chart review to evaluate: PET, histopathological, and clinical outcome parameters in consecutive patients undergoing curative intent trimodality treatment of Pancoast tumours from 2001 to 2015. Metabolic parameters based on the standardized uptake values (SUV) were calculated including SUV~max~ (maximum SUV value), SUV~PTL~ (peak tumour-to-liver ratio)~, ~and TGV (total glycolytic volume, mean SUV x tumour volume). Two pathologists independently reviewed specimens to assess percentage viable tumour in resected tumours.
Results:
Nineteen patients (10 Females), median age 61(42-75) yrs completed trimodality treatment with Cisplatin, Etoposide and 45Gy in the majority of cases. Histopathological was data available for all patients. Of the 19 patients baseline PET was available in 15 and post induction PET in 13. Baseline SUVmax < 9.4 was associated with pCR in 4/4 vs. 4/11 patients (p=0.03). A trend towards improved locoregional control with cPR did not reach significance. No PET measured parameter was associated with locoregional control. Baseline TGV > 441 was associated with reduced disease free survival (DFS) 5.7(0.7-10.5) vs. NR months (p=0.002), and overall survival (OS) 15.9(3.1-28.8) vs. NR months (p=0.04). No change in PET parameter measured post induction was associated with cPR, local recurrence, DFS or OS.
Conclusion:
In our series, low baseline SUV~max~ was associated with complete pathological response. If confirmed in a larger cohort, including multivariate analysis of other prognostic and predictive factors, this may allow patients at high perioperative risk to be better stratified to either definitive CRT or trimodality therapy. A larger series may be able to identify an association between metabolic response on FDG-PET and CPR, DFS or overall survival.
