The role of integrated 18F-FDG PET-CT as a staging tool for limited-stage small cell lung cancer: a retrospective study

Onkologie. 2012;35(7-8):432-8. doi: 10.1159/000341073. Epub 2012 Jul 3.

Abstract

Background: The aim of this study was to evaluate whether positron emission tomography-computed tomography (PET-CT) could be used as part of the staging work-up in patients with limited-stage disease (LD) small cell lung cancer (SCLC).

Patients and methods: Between January 2002 and December 2007, a total of 73 patients with presumed LD on CT, who underwent a PET-CT scan, were included in this study.

Results: Conventional work-up revealed distant metastases in 12 patients. Out of 61 patients diagnosed as LD SCLC, PET-CT found unexpected distant metastases in 15 (24.6%) patients (LD/extensive-stage disease (ED)) of whom 13 (21.3%) were upstaged as a consequence. In 10 (76.9%) of the 13 upstaged patients, treatment was changed. The median survival of LD/LD SCLC patients who underwent concurrent chemoradiotherapy and chemotherapy only was 21.9 and 17.5 months, respectively. The median survival of LD/ED and ED/ED SCLC patients who received chemotherapy only was 17.4 and 14.1 months, respectively. The median survival of LD/LD SCLC patients who received concurrent chemoradiotherapy was superior to that of LD/ ED and ED/ED patients who received chemotherapy only (p = 0.037 and 0.004, respectively).

Conclusion: The addition of PET-CT seems to allow more accurate staging and may thus protect a percentage of SCLC patients from potentially futile and toxic radiotherapy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Lung Neoplasms / pathology*
  • Male
  • Middle Aged
  • Multimodal Imaging / methods*
  • Neoplasm Staging
  • Positron-Emission Tomography*
  • Radiopharmaceuticals
  • Reproducibility of Results
  • Retrospective Studies
  • Sensitivity and Specificity
  • Small Cell Lung Carcinoma / pathology*
  • Systems Integration
  • Tomography, X-Ray Computed*

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18