Original investigationPrognostic Value of the Quantitative Metabolic Volumetric Measurement on 18F-FDG PET/CT in Stage IV Nonsurgical Small-cell Lung Cancer
Section snippets
Patient Recruitment
This study was approved by our hospital’s institutional review board and was compliant with the Health Insurance Portability and Accountability Act. We conducted a retrospective review of the medical records of patients with NSCLC. There were 816 cases with NSCLC who were diagnosed and treated in the University of Chicago Medical Center between January 1, 2004, and December 31, 2007. We identified the 92 consecutive nonsurgical patients with Stage IV NSCLC for this study from this retrospective
Results
The distribution of the gender and age, and PET/CT measurements with corresponding survival probabilities in 92 Stage IV nonsurgical patients with NSCLC are shown in Table 1. Table 1 gives descriptive statistics for all the patients and for subgroups based on PET measurements. Mean ± SD levels at baseline for MTV of whole body (MTVWB), TLG of whole body (TLGWB), SUVmean of whole body (SUVmeanWB), and SUVmax of whole body (SUVmaxWB) were: 248.21 ± 251.95 mL, 968.4 ± 1029.48 SUV∗mL, 3.78 ± 1.48,
Discussion
Currently, NSCLC TNM stage is the single most prognostic factor in predicting the outcomes of patients with lung cancer 25, 26, 27. The treatment for NSCLC depends mainly on the stage of the disease. Other factors such as age, pulmonary function, and comorbidity may also alter the selection of the treatment options. In early-stage NSCLC, surgical resection remains the standard of care in fit patients. In patients with unresectable locally advanced, Stage III NSCLC, chemotherapy in combination
Conclusion
Baseline whole-body metabolic tumor burden, as measured with MTV and TLG at the levels: 1) whole body tumor burden level and 2) primary tumor in PET/CT scans, provides a prognostic measurement with low interobserver variability in patients with the same clinical Stage IV NSCLC. This study also suggests pretreatment MTV and TLG values may be used to further stratify patients with Stage IV NSCLC and may be better prognostic measures than SUVmax and SUVmean measurements. These results will need to
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