Potential Use of (18)F-fluorodeoxyglucose Positron Emission Tomography-Based Quantitative Imaging Features for Guiding Dose Escalation in Stage III Non-Small Cell Lung Cancer

Int J Radiat Oncol Biol Phys. 2016 Feb 1;94(2):368-76. doi: 10.1016/j.ijrobp.2015.10.029. Epub 2015 Oct 30.

Abstract

Purpose: To determine whether previously identified quantitative image features (QIFs) based on (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) (co-occurrence matrix energy and solidity) are able to isolate subgroups of patients who would receive a benefit or detriment from dose escalation in terms of overall survival (OS) or progression-free survival (PFS).

Methods and materials: Subgroups of a previously analyzed 225 patient cohort were generated with the use of 5-percentile increment cutoff values of disease solidity and primary tumor co-occurrence matrix energy. The subgroups were analyzed with a log-rank test to determine whether there was a difference in OS and PFS between patients treated with 60 to 70 Gy and those receiving 74 Gy.

Results: In the entire patient cohort, there was no statistical difference in terms of OS or PFS between patients receiving 74 Gy and those receiving 60 to 70 Gy. It was qualitatively observed that as disease solidity and primary co-occurrence matrix energy increased, patients receiving 74 Gy had an improved OS and PFS compared with those receiving 60 to 70 Gy. The opposite trend (detriment of receiving 74 Gy) was also observed regarding low values of disease solidity and primary co-occurrence matrix energy.

Conclusions: FDG-PET-based QIFs were found to be capable of isolating subgroups of patients who received a benefit or detriment from dose escalation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Carcinoma, Non-Small-Cell Lung / diagnostic imaging*
  • Carcinoma, Non-Small-Cell Lung / mortality
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Carcinoma, Non-Small-Cell Lung / radiotherapy*
  • Female
  • Fluorodeoxyglucose F18 / administration & dosage*
  • Humans
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology
  • Lung Neoplasms / radiotherapy*
  • Male
  • Neoplasm Staging
  • Positron-Emission Tomography / statistics & numerical data*
  • Radiopharmaceuticals / administration & dosage*
  • Radiotherapy Dosage
  • Radiotherapy, Image-Guided / methods
  • Radiotherapy, Image-Guided / statistics & numerical data*
  • Reference Values

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18