Prognostic stratification using F-18 FDG PET/CT in patients with advanced stage (Stage III and IV) non-small cell lung cancer

F-18 FDG PET could provide prognostic information in patients with advanced resectable NSCLC. In the current study, we investigated the prognostic implication of F-18 FDG PET after chemotherapy in patients with advanced stage III and IV NSCLC. A retrospective review identified 19 patients with advanced stage (stage III and IV) NSCLC who received F-18 FDG PET/CT at diagnosis of cancer and after chemotherapy. The visual response and changes of SUV max before and after treatment on survival was investigated using Kaplan-Meier and Cox proportional hazard regression analyses. The median follow-up time was overall 24.8 month (range, 9.4 similar to 59.8 month), for surviving patients 41 month (range, 34.1 similar to 59.8 month), and for deceased patients 16.6 month (range, 9.4 similar to 29.4 month). Overall survival after baseline F-18 FDG PET/CT at 1 year was 73.7% and at 2 year was 47.4%. Comparing patients with and without F-18 FDG PET/CT response, there was statistically significant difference in overall survival between the 2 groups (median survival time, responder, 29.4 month; non-responder, 14.2 month, X-2=3.91, p=0.048). Also, using the %Delta SUVmax for the comparison, significant difference was existed in overall survival between 2 groups (X-2=12.6, p=0.0004). When the tumor reveals more than 17.85% reduction of %Delta SUVmax, the survival could be predicted (AUC, 0857; standard error, 0.0866; 95% confidence interval, 0.622 similar to 0.971; sensitivity, 75%; specificity, 100%; p=0.0001). With Cox proportional hazard model, %Delta SUVmax was determined to be a potent prognostic factor for survival (X-2, 12.09; p=0.0005). In conclusion, using the visual and quantitative analyses of F-18 FDG PET/CT, the responder to chemotherapy in advanced stage NSCLC patients had a better prognosis. Moreover, the potent predictor of prognosis in advanced stage NSCLC patients was