Journal
RADIOTHERAPY AND ONCOLOGY
Volume 101, Issue 2, Pages 291-297Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.radonc.2011.08.008
Keywords
Lung cancer; Stereotactic body radiotherapy; FDG-PET; Maximum standardized uptake value; Local recurrence; SMRT SUVmax
Funding
- Grants-in-Aid for Scientific Research [23591850] Funding Source: KAKEN
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Background: The maximum standardized uptake value (SUVmax) of FDG-PET may predict local recurrence for localized non-small-cell lung cancer (NSCLC) after stereotactic body radiotherapy (SBRT). Methods: Among 195 localized NSCLCs that were treated with total doses of either 40 Gy or 50 Gy in 5 SBRT fractions, we reviewed those patients who underwent pre-treatment FOG-PET using a single scanner for staging. Local control rates (LCRs) were obtained by the Kaplan-Meier method and a log-rank test. Prognostic significance was assessed by univariate and multivariate analyses. Results: A total of 95 patients with 97 lesions were eligible. Median follow-up was 16.0 months (range: 6.0-46.3 months). Local recurrences occurred in 9 lesions. By multivariate analysis, only the SUVmax of a primary tumor was a significant predictor (p = 0.002). Two years LCRs for lower SUVmax (< 6.0; n = 78) and higher SUVmax (>= 6; n = 19) were 93% and 42%, respectively. In subgroups with T1b and T2, LCRs were significantly better for lower SUVmax than for higher SUVmax (p < 0.0005 and p < 0.01). In both subgroups that received 40 Gy and 50 Gy, LCRs were also significantly better for lower SUVmax than for higher SUVmax (p < 0.001 and p < 0.01). Conclusions: SUVmax was the strongest predictor for local recurrence. A high SUVmax may be considered for dose escalation to improve local control. Additional follow-up is needed to determine if SUVmax is correlated with regional recurrence, distant metastasis, and survival. (C) 2011 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 101 (2011) 291-297
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