Early response to chemotherapy in patients with non-small-cell lung cancer assessed by [18F]-fluoro-deoxy-D-glucose positron emission tomography and computed tomography.

Abstract

BACKGROUND:

This study aimed to demonstrate that patients who exhibit a tumor metabolic response to first-line chemotherapy seen on FDG-PET and computed tomography (CT) would survive longer than those who did not show such a response, comparing this evaluation with the morphologic response seen on CT.

PATIENTS AND METHODS:

Images were acquired in 22 consecutive patients with advanced non-small-cell lung cancer (NSCLC) randomized to receive carboplatin/paclitaxel/sorafenib or placebo. FDG-PET was performed within 4 weeks before (PET1) and 2 weeks after starting treatment (PET2). Similarly, CT (CT1) was performed at baseline and then every 2 cycles (6 weeks) during treatment (CT2). Responders and nonresponders were identified with FDG-PET, and metabolic response was then compared with morphologic changes detected by spiral CT.

RESULTS:

Twenty-one of 22 patients completed this study. In terms of progression-free survival (PFS) (45 vs. 22.2 weeks) and overall survival (OS) (77 vs. 47.7 weeks), we observed a trend that was not statistically significant for patients whose response after 2 weeks of treatment was seen on FDG-PET (P = .22 for PFS; P = .15 for OS).

CONCLUSION:

Patients with advanced NSCLC who had a positive outcome, as evidenced by prolonged survival, were those who showed a tumor metabolic response seen on FDG-PET.

• Authors: Silvia Novello, Tiziana Vavalà, Matteo Giaj Levra, Federica Solitro, Ettore Pelosi, Andrea Veltri, Giorgio V Scagliotti
• Journal: Clinical lung cancer (Clin Lung Cancer) Vol. 14 Issue 3 Pg. 230-7 (May 2013) ISSN: 1938-0690 [Electronic] United States
• PMID: 23276821 (Publication Type: Clinical Trial, Phase III, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2013 Elsevier Inc. All rights reserved.

Chemical References

• Phenylurea Compounds
• Radiopharmaceuticals
• Fluorodeoxyglucose F18
• Niacinamide
• Sorafenib
• Carboplatin
• Paclitaxel

Topics

• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Carboplatin (administration & dosage)
• Carcinoma, Non-Small-Cell Lung (diagnostic imaging, drug therapy, mortality)
• Disease-Free Survival
• Female
• Fluorodeoxyglucose F18
• Humans
• Lung Neoplasms (diagnostic imaging, drug therapy, mortality)
• Male
• Middle Aged
• Multimodal Imaging
• Niacinamide (administration & dosage, analogs & derivatives)
• Paclitaxel (administration & dosage)
• Phenylurea Compounds (administration & dosage)
• Positron-Emission Tomography
• Prognosis
• Radiopharmaceuticals
• Sorafenib
• Tomography, X-Ray Computed