Prognostic significance of pretreatment PET parameters in inoperable, node-positive NSCLC patients with poor prognostic factors undergoing hypofractionated radiotherapy: a single-institution retrospective study.

Autor: Zinn AB; Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany., Kenndoff S; Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany., Holzgreve A; Department of Nuclear Medicine, University Hospital, LMU Munich, Marchioninistr, 15, 81377, Munich, Germany., Käsmann L; Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany.; German Cancer Consortium (DKTK), partner site Munich; and German Cancer Research Center (DKFZ), Heidelberg, Germany.; Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany., Guggenberger JE; Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany., Hering S; Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany., Mansoorian S; Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany., Schmidt-Hegemann NS; Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany., Reinmuth N; Department of Oncology, Asklepios Lung Clinic Munich-Gauting, Gauting, Germany., Tufman A; Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany.; Department of Medicine V, University Hospital, Munich, Germany., Dinkel J; Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany.; Department of Radiology, University Hospital, Munich, Germany.; Department of Radiology, Asklepios Lung Clinic Munich-Gauting, Gauting, Germany., Manapov F; Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany., Belka C; Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany.; German Cancer Consortium (DKTK), partner site Munich; and German Cancer Research Center (DKFZ), Heidelberg, Germany.; Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany.; Bavarian Cancer Research Center (BZKF), Munich, Germany., Eze C; Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany. Chukwuka.Eze@med.uni-muenchen.de.
Jazyk: angličtina
Zdroj: EJNMMI reports [EJNMMI Rep] 2024 Oct 08; Vol. 8 (1), pp. 32. Date of Electronic Publication: 2024 Oct 08.
DOI: 10.1186/s41824-024-00220-w
Abstrakt: Background: Node-positive non-small cell lung cancers (NSCLCs) present a challenge for treatment decisions, particularly in patients ineligible for concurrent chemoradiotherapy (CRT) due to poor performance status and compromised lung function. We aimed to investigate the prognostic value of pretreatment positron emission tomography (PET) parameters in high-risk patients undergoing hypofractionated radiotherapy.
Methods: A retrospective analysis was conducted on 42 consecutive patients with inoperable node-positive NSCLC, who underwent hypofractionated radiotherapy between 2014 and 2021 at a single institution. Clinical, treatment-related, and [ 18 F]FDG PET-based parameters were correlated with progression-free survival (PFS) and overall survival (OS). Median dichotomisation was performed to establish risk groups. Statistical analyses included univariable and multivariable Cox regression and Kaplan-Meier survival analyses.
Results: After a median follow-up of 47.1 months (range: 0.5-101.7), the median PFS and OS were 11.5 months (95% CI: 7.4-22.0), and 24.3 months (95% CI: 14.1-31.8). In univariable Cox regression analysis, significant predictors of PFS included receipt of salvage systemic treatment (p=0.007), SUVmax (p=0.032), and tMTV (p=0.038). Similarly, ECOG-PS (p=0.014), Histology (p=0.046), and tMTV (p=0.028) were significant predictors of OS. Multivariable Cox regression analysis (MVA) identified SUVmax as a significant predictor for PFS [HR: 2.29 (95% CI: 1.02-5.15); p=0.044]. For OS, ECOG-PS remained a significant prognosticator [HR: 3.53 (95% CI: 1.49-8.39); p=0.004], and tMTV approached significance [HR: 2.24 (95% CI: 0.95-5.26); p=0.065]. Furthermore, the high tMTV group exhibited a median PFS of 5.3 months [95% CI: 2.8-10.4], while the low tMTV group had a PFS of 15.2 months [95% CI: 10.1-33.5] (p=0.038, log-rank test). Median OS was 33.5 months [95% CI: 18.3-56.8] for tMTV ≤ 36.6 ml vs. 14.1 months [95% CI: 8.1-27.2] for tMTV > 36.6 ml (p=0.028, log-rank test).
Conclusion: Pretreatment PET parameters, especially tMTV, hold promise as prognostic indicators in NSCLC patients undergoing hypofractionated radiotherapy. The study highlights the potential of PET metrics as biomarkers for patient stratification.
(© 2024. The Author(s).)
Databáze: MEDLINE
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