The maximum standardized uptake value (SUVmax) on FDG-PET is a strong predictor of local recurrence for localized non-small-cell lung cancer after stereotactic body radiotherapy (SBRT)

Atsuya Takeda, Noriko Yokosuka, Toshio Ohashi, Etsuo Kunieda, Hirofumi Fujii, Yousuke Aoki, Naoko Sanuki, Naoyoshi Koike, Yukihiko Ozawa

Research output: Contribution to journalArticlepeer-review

74 Citations (Scopus)

Abstract

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 FDG-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.

Original languageEnglish
Pages (from-to)291-297
Number of pages7
JournalRadiotherapy and Oncology
Volume101
Issue number2
DOIs
Publication statusPublished - 2011 Nov 1

Keywords

  • FDG-PET
  • Local recurrence
  • Lung cancer
  • Maximum standardized uptake value
  • SMRT SUVmax
  • Stereotactic body radiotherapy

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging

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