Pre-op PET / CT predicted stage I NSCLC benefit of adjuvant chemotherapy -
By Lynda Williams, Senior medwireNews Reporter
preoperative imaging could help guide the use of postoperative adjuvant chemotherapy in patients with cancer of the early non-small cell lung (NSCLC), Japanese researchers believe.
Morihito Okada and colleagues from the University of Hiroshima, examined whether 18F-fluorodeoxyglucose positron emission tomography / computed tomography (FDG-PET / CT) results were significantly associated with outcomes of patients with stage T1b-2a NSCLC who were free node and metastatic disease.
The study included 174 patients with completely resected tumors, 0 received tegafur-uracil or adjuvant platinum-based chemotherapy and 84 did not.
Patients given adjuvant chemotherapy were significantly more likely than controls to achieve an interval without recurrence at 3 years (RFI, 0.6 vs 74.8%) and overall survival (OS 95.4 vs. 84.0%) than those who are not, the team reports in the Annals of Thoracic Surgery .
multivariate analysis, preoperative FDG-PET / CT normalized maximal absorption value (SUV max) of 2.6 or more predicted RFI significantly (relative risk [HR] = 8.03), while size greater than 30 mm tumor, pleural, vascular or lymphatic invasion were not significantly associated with RFI.
further analysis revealed that in patients with a maximum SUV of 2.6, those given adjuvant chemotherapy were significantly more likely than controls to achieve 3 years (RFI 82.8 vs 44.8%) and OS (93.0 vs 68.6%).
However, for patients with SUV max less than 2.6, adjuvant chemotherapy was not associated with significantly better survival.
The researchers suggest that the tumor size was not a significant predictor of results in their study because only participants with tumors with a diameter of 2 cm to 5 cm were enrolled.
In addition, FDG is associated with tumor growth in lung cancer, they said.
"We suggest not only the size of the tumor, but also the nature of the tumor defined by FDG-PET imaging / CT could predict the effectiveness of adjuvant chemotherapy," write Okada et al
They conclude :. "patients who are likely to derive greater benefit from adjuvant chemotherapy may be differentiated using SUV max together with the staging and the condition T" .
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