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Inicio Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) 18F-FDG PET/CT quantitative parameters as prognostic factors in localized and in...
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Vol. 39. Issue 6.
Pages 353-359 (November - December 2020)
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Vol. 39. Issue 6.
Pages 353-359 (November - December 2020)
Original Article
18F-FDG PET/CT quantitative parameters as prognostic factors in localized and inoperable lung cancer
Parámetros cuantitativos de la PET/TC con 18F-FDG como factores pronósticos en el cáncer de pulmón localizado e inoperable
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J.R. Infantea,
Corresponding author
infantetorre@gmail.com

Corresponding author.
, J. Cabrerab, J.I. Rayoa, C. Cruzc, J. Serranoa, M Morenoa, A. Martíneza, P. Jiméneza, A. Coboa
a Servicio de Medicina Nuclear, Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain
b Servicio de Oncología Radioterápica, Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain
c Servicio de Oncología Radioterápica, Hospital Punta de Europa, Algeciras, Cádiz, Spain
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Tables (5)
Table 1. Characteristics of the patients, tumoral lesions and radiation dose administered.
Table 2. Comparison of the different parameters between patients with and without biopsy.
Table 3. Metablic parameters.
Table 4. Univariate analysis of the prognostic factors.
Table 5. Cut-off points in ROC curves and their significance.
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Abstract
Aim

To assess the utility of [18F]FDG PET/CT quantitative parameters as prognostic factor in patients diagnosed with localized and inoperable lung cancer treated by stereotactic body radiotherapy (SBRT).

Material and methods

50 patients (42 men) diagnosed in the last 7 years with early-stage lung cancer and treated with SBRT alone were assessed by a prospective study. After PET/CT study, metabolic parameters maximum SUV (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were determined at different thresholds. The prognostic factors for overall survival (OS), cause-specific survival (CS) and disease-free survival (DFS) were analysed by Cox proportional hazards model and the survival analysis by Kaplan-Meier method.

Results

The average follow-up was 39.6 months, with 21 recurrences and 24 dead. Univariate analysis determined MTV30 and MTV40 as predictors for OS; MTV30, MTV40, TLG30 and TLG40 for CS and MTV2, MTV30, MTV40, TLG2, TLG30 and TLG40 for DFS. Survival analysis found statistically significant differences for CS and DFS depending on tumor size and for DFS considering the cut-off values of MTV2 and TLG2 (threshold SUVmax = 2). SUVmax, age and sex were not shown to be significant factors.

Conclusion

Pre-treatment quantitative assessment using metabolic parameters MTV2 and TLG2 as well as tumor size proved to be prognostic factors in patients diagnosed with localized and inoperable lung cancer treated by SBRT. Results could help to personalize treatment.

Keywords:
PET/CT
Lung cancer
SBRT
SUV
MTV
TLG
Resumen
Objetivo

Evaluar la utilidad de parámetros cuantitativos de la PET/TC con [18F]FDG como factores pronósticos en pacientes diagnosticados de cáncer de pulmón localizado e inoperable, tratado únicamente mediante radioterapia estereotáxica corporal (SBRT).

Material y métodos

Se valoraron mediante estudio prospectivo 50 pacientes (42 hombres) diagnosticados en los últimos 7 años de neoplasia pulmonar en estadios precoces y tratados únicamente mediante SBRT. Tras realización del estudio PET/TC, se determinaron los parámetros metabólicos SUV máximo (SUVmax), volumen metabólico tumoral (MTV) y glicolisis tumoral total (TLG) a diferentes umbrales. Se analizaron los factores pronósticos para la supervivencia global (SG), supervivencia por causa específica (SCE) y supervivencia libre de enfermedad (SLE) mediante regresión de Cox y las curvas de supervivencia mediante el método de Kaplan-Meier.

Resultados

El seguimiento medio fue de 39,6 meses, produciéndose 21 recurrencias y 24 exitus. El análisis determinó como factores predictivos MTV30 y MTV40 para la SG; MTV30, MTV40, TLG30 y TLG40 para la SCE; y MTV2, MTV30, MTV40, TLG2, TLG30 y TLG40 para la SLE. El análisis de supervivencia halló diferencias estadísticamente significativas para la SCE y la SLE dependiendo del tamaño tumoral y para la SLE dependiendo de los valores de MTV2 y TLG2 (umbral de SUVmax = 2). El SUVmax, la edad y el sexo no fueron factores significativos.

Conclusión

La valoración cuantitativa pretratamiento mediante los parámetros metabólicos MTV2 y TLG2, así como el tamaño tumoral demostraron ser factores pronósticos en pacientes con neoplasia pulmonar localizada e inoperable tratados mediante SBRT. Los resultados podrían ayudar a personalizar el tratamiento.

Palabras clave:
PET/TC
Cáncer de pulmón
SBRT
SUV
MTV
TLG

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