F-Fluorodeoxyglucose Positron Emission Tomography versus Computed Tomography in Predicting Histopathological Response to Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitor Treatment in Resectable Non-Small Cell Lung Cancer.

Autor: van Gool, Matthijs, Aukema, Tjeerd, Schaake, Eva, Rijna, Herman, Codrington, Henk, Valdés Olmos, Renato, Teertstra, Hendrik, van Pel, Renee, Burgers, Sjaak, van Tinteren, Harm, Klomp, Houke
Zdroj: Annals of Surgical Oncology: An Oncology Journal for Surgeons; Sep2014, Vol. 21 Issue 9, p2831-2837, 7p
Abstrakt: Purpose: To prospectively evaluate diagnostic computed tomography (CT) and F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for identification of histopathologic response to neoadjuvant erlotinib, an epidermal growth factor receptor-tyrosine kinase inhibitor in patients with resectable non-small cell lung cancer (NSCLC). Methods: This study was designed as an open-label phase 2 trial, performed in four hospitals in the Netherlands. Patients received preoperative erlotinib 150 mg once daily for 3 weeks. CT and FDG-PET/CT were performed at baseline and after 3 weeks of treatment. CT was assessed according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. FDG-PET/CT, tumor FDG uptake, and changes were measured by standardized uptake values (SUV). Radiologic and metabolic responses were compared to the histopathological response. Results: Sixty patients were enrolled onto this study. In 53 patients (22 men, 31 women), the combination of CT, FDG-PET/CT, and histopathological evaluation was available for analysis. Three patients (6 %) had radiologic response. According to European Organisation for Research and Treatment of Cancer (EORTC) criteria, 15 patients (28 %) showed metabolic response. In 11 patients, histopathologic response (≥50 % necrosis) was seen. In predicting histopathologic response, relative FDG change in SUV showed more SUV decrease in the histopathologic response group (−32 %) versus the group with no pathologic response (−4 %) ( p = 0.0132). Relative change in tumor size on diagnostic CT was similar in these groups with means close to 0. Conclusions: FDG-PET/CT has an advantage over CT as a predictive tool to identify histopathologic response after 3 weeks of EGFR-TKI treatment in NSCLC patients. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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