Tumour metabolic activity measured by fluorodeoxyglucose positron emission tomography for radiotherapy planning as a prognostic factor for locally advanced non-small cell lung cancer.

OBJECTIVES: To analyse whether the maximum standardized uptake value of the positron emission tomography/computed tomography for radiotherapy planning was useful as a prognostic factor for tumour response and survival of patients with locally advanced non-small cell lung cancer.

BACKGROUND: Increased 18F-fluoro-2-deoxyglucose uptake by lung cancer cells, measured as the maximum standardized uptake value, has been reported to predict the biologic aggressiveness of both early and advanced non-small cell lung cancer.

METHODS: A prospective study was performed in 61 consecutive patients with unresectable stage IA-IIIB of non-small cell lung cancer. The mean age was 65 years. Seventy five percent of patients in the entire group received an induction chemotherapy. The mean dose of radiotherapy was 61Gy. All patients underwent 18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography for radiotherapy planning.

RESULTS: Thirty six percent of the patients experienced a complete response and 20 % had a partial tumour response. Forty four percent of the patients suffered from a progressive disease. The maximum standardized uptake value of the primary tumour more than 11.4 was correlated with a worse tumour response (p = 0.0001) and a shorter survival of our patients (p = 0.0109).

CONCLUSION: We found a correlation between the maximum standardized uptake value and the patient prognosis and lung cancer aggressiveness (Tab. 3, Fig. 5, Ref. 18).