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Early lesion-specific (18)F-FDG PET response to chemotherapy predicts time to lesion progression in locally advanced non-small cell lung cancer

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@article{89de3f70339040fdb8a2cbb30b16996e,
title = "Early lesion-specific (18)F-FDG PET response to chemotherapy predicts time to lesion progression in locally advanced non-small cell lung cancer",
abstract = "BACKGROUND AND PURPOSE: We hypothesize that the lesion-to-lesion variability in FDG-PET response after one cycle of chemotherapy for NSCLC in an individual patient may inform radiation dose redistribution. To test this hypothesis, we investigate if time to lesion-progression in patients with multiple lesions is dependent on lesion-specific response to chemotherapy.MATERIALS AND METHODS: We analyzed 81 patients with 184 lesions referred to curative chemo-radiotherapy for NSCLC 2010-2012. (18)F-FDG PET scans were performed at diagnosis and after one series of chemotherapy. Response of each lesion was assessed as the change in FDG peak standardized uptake value. Variance of lesion response was compared within and between patients. Time to progression for each lesion was analyzed using the Kaplan-Meier method and the Cox proportional hazards model.RESULTS: Within-patient variability in lesion responses was of the same magnitude as the between-patient variability. Lesion-specific time to progression was longer in lesions with a better response (log-rank p=0.038). Nodal lesions had a much lower risk of progression than T-site lesions (HR=0.09, p<0.0001).CONCLUSIONS: Recording an overall patient response involves a loss of biological information on heterogeneity between lesions. Poor lesion-specific response after one cycle chemotherapy may identify lesions that would benefit from an individualized radiotherapy strategy.",
keywords = "Adult, Aged, Aged, 80 and over, Carcinoma, Non-Small-Cell Lung, Chemoradiotherapy, Disease Progression, Female, Fluorodeoxyglucose F18, Humans, Lung Neoplasms, Male, Middle Aged, Positron-Emission Tomography, Proportional Hazards Models, Radiopharmaceuticals, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't",
author = "Lotte Nyg{\aa}rd and Vogelius, {Ivan R} and Fischer, {Barbara M} and Klausen, {Thomas L} and Langer, {Seppo W} and Lonsdale, {Markus N} and Persson, {Gitte F} and Bentzen, {S{\o}ren M}",
note = "Copyright {\circledC} 2016 Elsevier Ireland Ltd. All rights reserved.",
year = "2016",
month = "3",
doi = "10.1016/j.radonc.2016.01.009",
language = "English",
volume = "118",
pages = "460--4",
journal = "Radiotherapy and Oncology",
issn = "0167-8140",
publisher = "Elsevier Ireland Ltd",
number = "3",

}

RIS

TY - JOUR

T1 - Early lesion-specific (18)F-FDG PET response to chemotherapy predicts time to lesion progression in locally advanced non-small cell lung cancer

AU - Nygård, Lotte

AU - Vogelius, Ivan R

AU - Fischer, Barbara M

AU - Klausen, Thomas L

AU - Langer, Seppo W

AU - Lonsdale, Markus N

AU - Persson, Gitte F

AU - Bentzen, Søren M

N1 - Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

PY - 2016/3

Y1 - 2016/3

N2 - BACKGROUND AND PURPOSE: We hypothesize that the lesion-to-lesion variability in FDG-PET response after one cycle of chemotherapy for NSCLC in an individual patient may inform radiation dose redistribution. To test this hypothesis, we investigate if time to lesion-progression in patients with multiple lesions is dependent on lesion-specific response to chemotherapy.MATERIALS AND METHODS: We analyzed 81 patients with 184 lesions referred to curative chemo-radiotherapy for NSCLC 2010-2012. (18)F-FDG PET scans were performed at diagnosis and after one series of chemotherapy. Response of each lesion was assessed as the change in FDG peak standardized uptake value. Variance of lesion response was compared within and between patients. Time to progression for each lesion was analyzed using the Kaplan-Meier method and the Cox proportional hazards model.RESULTS: Within-patient variability in lesion responses was of the same magnitude as the between-patient variability. Lesion-specific time to progression was longer in lesions with a better response (log-rank p=0.038). Nodal lesions had a much lower risk of progression than T-site lesions (HR=0.09, p<0.0001).CONCLUSIONS: Recording an overall patient response involves a loss of biological information on heterogeneity between lesions. Poor lesion-specific response after one cycle chemotherapy may identify lesions that would benefit from an individualized radiotherapy strategy.

AB - BACKGROUND AND PURPOSE: We hypothesize that the lesion-to-lesion variability in FDG-PET response after one cycle of chemotherapy for NSCLC in an individual patient may inform radiation dose redistribution. To test this hypothesis, we investigate if time to lesion-progression in patients with multiple lesions is dependent on lesion-specific response to chemotherapy.MATERIALS AND METHODS: We analyzed 81 patients with 184 lesions referred to curative chemo-radiotherapy for NSCLC 2010-2012. (18)F-FDG PET scans were performed at diagnosis and after one series of chemotherapy. Response of each lesion was assessed as the change in FDG peak standardized uptake value. Variance of lesion response was compared within and between patients. Time to progression for each lesion was analyzed using the Kaplan-Meier method and the Cox proportional hazards model.RESULTS: Within-patient variability in lesion responses was of the same magnitude as the between-patient variability. Lesion-specific time to progression was longer in lesions with a better response (log-rank p=0.038). Nodal lesions had a much lower risk of progression than T-site lesions (HR=0.09, p<0.0001).CONCLUSIONS: Recording an overall patient response involves a loss of biological information on heterogeneity between lesions. Poor lesion-specific response after one cycle chemotherapy may identify lesions that would benefit from an individualized radiotherapy strategy.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Carcinoma, Non-Small-Cell Lung

KW - Chemoradiotherapy

KW - Disease Progression

KW - Female

KW - Fluorodeoxyglucose F18

KW - Humans

KW - Lung Neoplasms

KW - Male

KW - Middle Aged

KW - Positron-Emission Tomography

KW - Proportional Hazards Models

KW - Radiopharmaceuticals

KW - Journal Article

KW - Research Support, N.I.H., Extramural

KW - Research Support, Non-U.S. Gov't

U2 - 10.1016/j.radonc.2016.01.009

DO - 10.1016/j.radonc.2016.01.009

M3 - Journal article

VL - 118

SP - 460

EP - 464

JO - Radiotherapy and Oncology

JF - Radiotherapy and Oncology

SN - 0167-8140

IS - 3

ER -

ID: 49699097