DOI QR코드

DOI QR Code

Staging with PET-CT in Patients with Locally Advanced Non Small Cell Lung Cancer is Superior to Conventional Staging Methods in Terms of Survival

  • Mutlu, Hasan (Department of Medical Oncology, Acibadem Kayseri Hospital) ;
  • Buyukcelik, Abdullah (Department of Internal Medicine, Acibadem University School of Medicine) ;
  • Erden, Abdulsamet (Department of Internal Medicine, Kayseri Training and Research Hospital) ;
  • Aslan, Tuncay (Department of Internal Medicine, Kayseri Training and Research Hospital) ;
  • Akca, Zeki (Department of Radiation Oncology, Mersin Government Hospital) ;
  • Kaya, Eser (Department of Nuclear Medicine, Acibadem Kayseri Hospital) ;
  • Kibar, Mustafa (Department of Nuclear Medicine, Acibadem Adana Hospital) ;
  • Seyrek, Ertugrul (Department of Medical Oncology, Acibadem Adana Hospital) ;
  • Yavuz, Sinan (Department of Internal Medicine, Acibadem University School of Medicine) ;
  • Calikusu, Zuleyha (Department of Medical Oncology, Acibadem Adana Hospital)
  • Published : 2013.06.30

Abstract

Background: Of patients with non small cell lung cancer (NSCLC), around one third are locally advanced at the time of diagnosis. Because only a proprotion of stage III patients can be cured by surgery, in order to improve the outcomes, sequential or concurrent chemoradiation, or concurrent chemoradiation with induction or consolidation is offered to the patients with locally advanced NSCLC. Today, PET combined with computerized tomography (PET-CT) is accepted as the most sensitive technique for detecting mediastinal lymph node and extracranial metastases from NSCLC. We aimed to compare PET-CT and conventional staging procedures for decisions regarding curative treatment of locally advanced NSCLC. Materials and Methods: A total of 168 consecutive patients were included from Acibadem Kayseri Hospital, Acibadem Adana Hospital and Kayseri Research and Training Hospital in this study. Results: While the median PFS was $13.0{\pm}1.9$ months in the PET-CT group, it was only $6.0{\pm}0.9$ in the others (p<0.001). The median OS values were $20.5{\pm}15.6$ and $11.5{\pm}1.5$ months, respectively (p<0.001). Discussion: As a result, we found that staging with PET CT has better results in terms of survival staging. This superiority leads to survival advantage in patients with locally advanced NSCLC.

Keywords

Lung cancer;locally advanced;PET CT;survival

References

  1. Brown T, Pilkington G, Boland A, et al (2013). Clinical effectiveness of first-line chemoradiation for adult patients with locally advanced non-small cell lung cancer: a systematic review. Health Technol Assess, 17, 1-99.
  2. Christian Fink (2010). In: Christian manegold, editor. Non small cell lung cancer treatment 2nd edition. Bremen: Int Med Pub, 6, 68-77.
  3. Curran WJ Jr, Paulus R, Langer CJ, et al (2011). Sequential vs. concurrent chemoradiation for stage III non-small cell lung cancer: randomized phase III trial RTOG 9410. J Natl Cancer Inst, 103, 1452-60. https://doi.org/10.1093/jnci/djr325
  4. Demirci E, Daloglu F, Gundogdu C, et al (2013). Incidence and clinicopathologic features of primary lung cancer: a northeastern anatolia region study in Turkey (2006-2012). Asian Pac J Cancer Prev, 14, 1989-93. https://doi.org/10.7314/APJCP.2013.14.3.1989
  5. Dillman RO, Herndon J, Seagren SL, Eaton WL Jr, Green MR (1996). Improved survival in stage III non-small-cell lung cancer: seven-year follow-up of cancer and leukemia group B (CALGB) 8433 trial. J Natl Cancer Inst, 88, 1210-5. https://doi.org/10.1093/jnci/88.17.1210
  6. Ding XP, Zhang J, Li BS, et al (2012). Feasibility of shrinking field radiation therapy through 18F-FDG PET/CT after 40 Gy for stage III non-small cell lung cancers. Asian Pac J Cancer Prev, 13, 319-23. https://doi.org/10.7314/APJCP.2012.13.1.319
  7. Driesen P, Lambrechts M, Kraaij K, et al (2013). A phase II single-arm study of induction chemotherapy with cisplatin and gemcitabine followed byconcurrent cisplatin and gemcitabine with thoracic radiation for unresectable locally advanced non-small cell lung cancer. Ther Adv Med Oncol, 5, 159-68. https://doi.org/10.1177/1758834013481021
  8. Furuse K, Fukuoka M, Kawahara M, et al (1999). Phase III study of concurrent versus sequential thoracic radiotherapy in combination with mitomycin, vindesine, and cisplatin in unresectable stage III non-small-cell lung cancer. J Clin Oncol, 17, 2692-9.
  9. Gamez C, Rosell R, Fernandez A, et al (2006). PET/CT fusion scan in lung cancer: current recommendations and innovations. J Thorac Oncol, 1, 74-7. https://doi.org/10.1097/01243894-200601000-00015
  10. Gandara DR, Chansky K, Albain KS, et al (2003). Southwest oncology group. Consolidation docetaxel after concurrent chemoradiotherapy in stage IIIB non-small-cell lung cancer: phase II southwest oncology group study S9504. J Clin Oncol, 21, 2004-10. https://doi.org/10.1200/JCO.2003.04.197
  11. Gregoire V, Haustermans K, Geets X, Roels S, Lonneux M (2007). PET-based treatment planning in radiotherapy: a new standard? J Nucl Med, 48, 68-77.
  12. Gupta NC, Graeber GM, Rogers JS, Bishop HA (1999). Comparative efficacy of positron emission tomography with FDG and computed tomographic scanning in preoperative staging of non-small cell lung cancer. Ann Surg, 229, 286-91. https://doi.org/10.1097/00000658-199902000-00018
  13. Marshall HM, Leong SC, Bowman RV, Yang IA, Fong KM (2012). The science behind the 7th edition Tumour, Node, Metastasis staging system for lung cancer. Respirology, 17, 247-60. https://doi.org/10.1111/j.1440-1843.2011.02083.x
  14. Le Chevalier T, Arriagada R, Tarayre M, et al (1992). Significant effect of adjuvant chemotherapy on survival in locally advanced non-small-cell lung carcinoma. J Natl Cancer Inst, 84, 58. https://doi.org/10.1093/jnci/84.1.58
  15. Albain KS, Crowley JJ, Turrisi AT, et al (2002). Concurrent cisplatin, etoposide, and chest radiotherapy in pathologic stage IIIB non-small-cell lung cancer: a southwest oncology group phase II study, SWOG 9019. J Clin Oncol, 20, 3454-60. https://doi.org/10.1200/JCO.2002.03.055
  16. Antoch G, Stattaus J, Nemat AT, et al (2003). Non-small cell lung cancer: dual-modality PET/CT in preoperative staging. Radiology, 229, 526-33. https://doi.org/10.1148/radiol.2292021598
  17. Belani CP, Choy H, Bonomi P, et al (2005). Combined chemoradiotherapy regimens of paclitaxel and carboplatin for locally advanced non-small-cell lung cancer: a randomized phase II locally advanced multi-modality protocol. J Clin Oncol, 23, 5883-91. https://doi.org/10.1200/JCO.2005.55.405
  18. Birim O, Kappetein AP, Stijnen T, Bogers AJ (2005). Metaanalysis of positron emission tomographic and computed tomographic imaging in detecting mediastinal lymph node metastases in nonsmall cell lung cancer. Ann Thorac Surg, 79, 375-82. https://doi.org/10.1016/j.athoracsur.2004.06.041
  19. Li J, Xu W, Kong F, Sun X, Zuo X (2013). Meta-analysis: Accuracy of 18FDG PET-CT for distant metastasis staging in lung cancer patients. Surg Oncol, [Epub ahead of print].
  20. Paesmans M, Berghmans T, Dusart M, et al (2010). Primary tumor standardized uptake value measured on fluorodeoxyglucose positron emission tomography is of prognostic value for survival in non-small cell lung cancer: update of a systematic review and meta-analysis by the European lung cancer working party for the international association for the study of lung cancer staging project. Thorac Oncol, 5, 612-9.
  21. Parkin DM, Bray F, Ferlay J, Pisani P (2005). Global cancer statistics, 2002. CA Cancer J Clin, 55, 74-108. https://doi.org/10.3322/canjclin.55.2.74
  22. Sause WT, Scott C, Taylor S, et al (1995). Radiation therapy oncology group (RTOG) 88-08 and eastern cooperative oncology group (ECOG) 4588: preliminary results of a phase III trial in regionally advanced, unresectable non-small-cell lung cancer. J Natl Cancer Inst, 87, 198-205. https://doi.org/10.1093/jnci/87.3.198
  23. Schrevens L, Lorent N, Dooms C, Vansteenkiste J (2004). The role of PET scan in diagnosis, staging, and management of non-small cell lung cancer. Oncologist, 9, 633-43. https://doi.org/10.1634/theoncologist.9-6-633
  24. Silvestri GA, Gonzalez AV, Jantz MA, et al (2013). Methods for staging non-small cell lung cancer: diagnosis and management of lung cancer, 3rd ed: American college of chest physicians evidence-based clinical practice guidelines. Chest. 143, 211-50. https://doi.org/10.1378/chest.12-2355
  25. Tachfouti N, Belkacemi Y, Raherison C, et al (2012). First data on direct costs of lung cancer management in Morocco. Asian Pac J Cancer Prev, 13, 1547-51. https://doi.org/10.7314/APJCP.2012.13.4.1547
  26. Vokes EE, Herndon JE , Kelley MJ, et al (2007). Induction chemotherapy followed by chemoradiotherapy compared with chemoradiotherapy alone for regionally advanced unresectable stage III Non-small-cell lung cancer: cancer and leukemia group B. J Clin Oncol, 25, 1698-704. https://doi.org/10.1200/JCO.2006.07.3569
  27. Wang J, Liu F, Huang DX, Jiang B (2012). Post-operative treatment with cisplatin and vinorelbine in Chinese patients with non-small cell lung cancer: a clinical prospective analysis of 451 patients. Asian Pac J Cancer Prev, 13, 4505-10. https://doi.org/10.7314/APJCP.2012.13.9.4505
  28. Zatloukal P, Petruzelka L, Zemanova M, et al (2004). Concurrent versus sequential chemoradiotherapy with cisplatin and vinorelbine in locally advanced non-small cell lung cancer: a randomized study. Lung Cancer, 46, 87-98. https://doi.org/10.1016/j.lungcan.2004.03.004

Cited by

  1. Edition Staging System vol.15, pp.6, 2014, https://doi.org/10.7314/APJCP.2014.15.6.2465
  2. Diagnostic Accuracy of 18F-FDG-PET in Patients with Testicular Cancer: a Meta-analysis vol.15, pp.8, 2014, https://doi.org/10.7314/APJCP.2014.15.8.3525
  3. Potential Impact of Atelectasis and Primary Tumor Glycolysis on F-18 FDG PET/CT on Survival in Lung Cancer Patients vol.15, pp.9, 2014, https://doi.org/10.7314/APJCP.2014.15.9.4085
  4. Differences in the Prognostic Significance of the SUVmax between Patients with Resected Pulmonary Adenocarcinoma and Squamous Cell Carcinoma vol.15, pp.23, 2015, https://doi.org/10.7314/APJCP.2014.15.23.10171
  5. Role of PET/CT in Treatment Planning for Head and Neck Cancer Patients Undergoing Definitive Radiotherapy vol.15, pp.24, 2015, https://doi.org/10.7314/APJCP.2014.15.24.10899
  6. A New Tool to Predict Survival after Radiosurgery Alone for Newly Diagnosed Cerebral Metastases vol.16, pp.7, 2015, https://doi.org/10.7314/APJCP.2015.16.7.2967
  7. FDG-PET/CT and diffusion-weighted imaging for resected lung cancer: correlation of maximum standardized uptake value and apparent diffusion coefficient value with prognostic factors vol.35, pp.5, 2018, https://doi.org/10.1007/s12032-018-1128-1