SUVmax predicts outcome in advanced NSCLC

By Laura Cowen, medwireNews Reporter

Parameters measured by positron emission tomography with integrated computed tomography (PET-CT) at diagnosis can be used to predict outcome following concurrent chemoradiotherapy for stage III non-small-cell lung cancer (NSCLC), research shows.

Specifically, a maximum standardised uptake value of positive nodes (SUV_max nodes) below 8 was a significant predictor of longer progression-free survival (PFS), distant metastasis-free survival (DMFS) and overall survival (OS) in a study by Victor Lee and colleagues from the University of Hong Kong.

The authors explain that previous studies have identified SUV of the primary tumour as a prognostic marker in NSCLC, but these studies were based on heterogeneous patient populations receiving a variety of treatment modalities.

To address this, the team looked for predictors of survival in 43 patients (mean age 59 years, 84% men) with surgically unresectable stage III NSCLC who were all treated with definitive chemoradiotherapy between 2006 and 2012. All patients had a pretreatment PET-CT scan.

After a median follow-up period of 41.5 months, the median PFS, DMFS, and OS were 14.1, 12.6 and 37.8 months, respectively.

PFS was significantly longer for patients with stage IIIA rather than stage IIIB tumours (38.6 vs 13.5 months) and for patients with N0 to N2 disease versus N3 disease (16.7 vs 8.1 months).

A planning target volume (PTV) below 500 cm³ was associated with longer PFS than a PTV at or above 500 cm³ (23.6 vs 11.3 months) and PFS advantage was also observed for patients with SUV_max nodes below 8 versus 8 or above (16.1 vs 10.7 months).

For DMFS, lower PTV and lower SUV_max were significant prognostic factors, while lower stage and lower SUV_max significantly predicted OS.

Writing in the American Journal of Clinical Oncology, the researchers conclude that SUV_max nodes is a new metabolic marker that has “significant prognostic value in patients with stage III NSCLC treated with radical concurrent chemoradiotherapy”.

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