Aim: To investigate predictive and prognostic role of metabolic parameters using [ F]-2-fluoro-2-deoxy-D-glucose positron emission tomography ( F-FDG PET) in patients with locally advanced non-small cell lung cancer (NSCLC) treated with docetaxel-platinum induction chemotherapy (IC).
Methods: Medical records of 31 patients with pre- and post-IC F-FDG PET were reviewed. Using F-FDG PET, metabolic parameters, including metabolic tumor response, adjusted peak standardized uptake values using lean body mass at baseline (pre-SUL ) and after IC (post-SUL ), and percentage change of pre- and post-SUL (ΔSUL ), were assessed.
Results: Response rate (RR) was 71%, with a metabolic RR of 83.9%. Nineteen (61.3%) patients underwent surgery, R0 resection was achieved for 17 (89.5%) patients. Median relapse-free survival (RFS) and overall survival (OS) were 8.9 months (95% CI: 4.5-12.1) and 24.1 months (95% CI: 17.1-34.1), respectively. Post-SUL < 2 was identified as a favorable prognostic factor for RFS (hazard ratio [HR]: 0.12; P = .004), while ΔSUL ≥60% and R0 resection were found as positive prognostic factors for OS (HR: 0.09 and 0.13; P = .011 and P = .042, respectively). Using a receiver operating characteristics curve, post-SUL > 1.4 could predict recurrence with a sensitivity of 84% and a specificity of 100%.
Conclusion: In patients with locally advanced NSCLC receiving IC, post-SUL and ΔSUL showed clinical significance for survival outcome.
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