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High Impact of 18F-FDG-PET on Management and Prognostic Stratification of Newly Diagnosed Small Cell Lung Cancer

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Abstract

Purpose

We evaluated whether 18F-FDG-PET altered stage classification, management, and prognostic stratification of newly diagnosed small cell lung cancer (SCLC).

Procedures

We identified 46 consecutive patients undergoing staging positron emission tomography for SCLC from 1993–2008 inclusive. Updated survival data from the state Cancer Registry was available on 42 of 46 patients.

Results

PET altered stage classification in 12 of 46 (26%) patients. PET altered treatment modality in nine patients, and the target mediastinal radiation field in another three patients. Therefore, PET altered management in 12 of 46 (26%) patients. Patients with limited disease (LD) on pre-PET staging had significantly longer overall survival (OS) than those upstaged to extensive disease (ED; median 18.6 months versus 5.7 months; log-rank p < 0.0001). In patients with ED on pre-PET staging, those downstaged to LD by PET had significantly longer OS than those with ED on PET (median 10.9 months versus 5.9 months; log-rank p = 0.037).

Conclusion

PET had a major impact on stage classification, management, and prognostic stratification of newly diagnosed SCLC.

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References

  1. Australian Institute of Health and Welfare (AIHW) and Australasian Association of Cancer Registries (AACR; 2007) Cancer in Australia: an overview, 2006. Cancer series no. 37. Cat. no. CAN 32. Canberra: AIHW)

  2. Govindan R, Page N, Morgensztern D et al (2006) Changing epidemiology of small-cell lung cancer in the United States over the last 30 years: analysis of the surveillance, epidemiologic, and end results database. J Clin Oncol 24:4539–4544

    Article  PubMed  Google Scholar 

  3. Lally BE, Urbanic JJ, Blackstock AW, Miller AA, Perry MC (2007) Small cell lung cancer: have we made any progress over the last 25 years? Oncologist 12:1096–1104

    Article  PubMed  Google Scholar 

  4. Blum R, MacManus MP, Rischin D, Michael M, Ball D, Hicks RJ (2004) Impact of positron emission tomography on the management of patients with small-cell lung cancer: preliminary experience. Am J Clin Oncol 27:164–171

    Article  PubMed  Google Scholar 

  5. Warde P, Payne D (1992) Does thoracic irradiation improve survival and local control in limited-stage small-cell carcinoma of the lung? A meta-analysis. J Clin Oncol 10:890–895

    CAS  PubMed  Google Scholar 

  6. Pignon JP, Arriagada R, Ihde DC et al (1992) A meta-analysis of thoracic radiotherapy for small-cell lung cancer. N Engl J Med 327:1618–1624

    Article  CAS  PubMed  Google Scholar 

  7. Takada M, Fukuoka M, Kawahara M et al (2002) Phase III study of concurrent versus sequential thoracic radiotherapy in combination with cisplatin and etoposide for limited-stage small-cell lung cancer: results of the Japan Clinical Oncology Group Study 9104. J Clin Oncol 20:3054–3060

    Article  CAS  PubMed  Google Scholar 

  8. Murray N, Coy P, Pater JL et al (1993) Importance of timing for thoracic irradiation in the combined modality treatment of limited-stage small-cell lung cancer. The National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol 11:336–344

    CAS  PubMed  Google Scholar 

  9. Turrisi AT 3rd, Kim K, Blum R et al (1999) Twice-daily compared with once-daily thoracic radiotherapy in limited small-cell lung cancer treated concurrently with cisplatin and etoposide. N Engl J Med 340:265–271

    Article  CAS  PubMed  Google Scholar 

  10. Simon M, Argiris A, Murren JR (2004) Progress in the therapy of small cell lung cancer. Crit Rev Oncol Hematol 49:119–133

    Article  PubMed  Google Scholar 

  11. Bradley JD, Dehdashti F, Mintun MA, Govindan R, Trinkaus K, Siegel BA (2004) Positron emission tomography in limited-stage small-cell lung cancer: a prospective study. J Clin Oncol 22:3248–3254

    Article  PubMed  Google Scholar 

  12. Fischer BM, Mortensen J, Langer SW et al (2007) A prospective study of PET/CT in initial staging of small-cell lung cancer: comparison with CT, bone scintigraphy and bone marrow analysis. Ann Oncol 18:338–345

    Article  CAS  PubMed  Google Scholar 

  13. Vinjamuri M, Craig M, Campbell-Fontaine A, Almubarak M, Gupta N, Rogers JS (2008) Can positron emission tomography be used as a staging tool for small-cell lung cancer? Clin Lung Cancer 9:30–34

    Article  PubMed  Google Scholar 

  14. Brink I, Schumacher T, Mix M et al (2004) Impact of [18F]FDG-PET on the primary staging of small-cell lung cancer. Eur J Nucl Med Mol Imaging 31:1614–1620

    Article  CAS  PubMed  Google Scholar 

  15. Schumacher T, Brink I, Mix M et al (2001) FDG-PET imaging for the staging and follow-up of small cell lung cancer. Eur J Nucl Med 28:483–488

    Article  CAS  PubMed  Google Scholar 

  16. Kut V, Spies W, Spies S, Gooding W, Argiris A (2007) Staging and monitoring of small cell lung cancer using [18F]fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET). Am J Clin Oncol 30:45–50

    Article  PubMed  Google Scholar 

  17. Shen YY, Shiau YC, Wang JJ, Ho ST, Kao CH (2002) Whole-body 18F-2-deoxyglucose positron emission tomography in primary staging small cell lung cancer. Anticancer Res 22:1257–1264

    PubMed  Google Scholar 

  18. Kamel EM, Zwahlen D, Wyss MT, Stumpe KD, von Schulthess GK, Steinert HC (2003) Whole-body (18)F-FDG PET improves the management of patients with small cell lung cancer. J Nucl Med 44:1911–1917

    PubMed  Google Scholar 

  19. Scott AM, Gunawardana DH, Kelley B et al (2008) PET changes management and improves prognostic stratification in patients with recurrent colorectal cancer: results of a multicenter prospective study. J Nucl Med 49:1451–1457

    Article  PubMed  Google Scholar 

  20. Munley MT, Marks LB, Scarfone C et al (1999) Multimodality nuclear medicine imaging in three-dimensional radiation treatment planning for lung cancer: challenges and prospects. Lung Cancer 23:105–114

    Article  CAS  PubMed  Google Scholar 

  21. van Loon J, Offermann C, Bosmans G et al (2008) 18FDG-PET based radiation planning of mediastinal lymph nodes in limited disease small cell lung cancer changes radiotherapy fields: a planning study. Radiother Oncol 87:49–54

    Article  PubMed  Google Scholar 

  22. Onitilo AA, Engel JM, Demos JM, Mukesh B (2008) Prognostic significance of 18 F-fluorodeoxyglucose - positron emission tomography after treatment in patients with limited stage small cell lung cancer. Clin Med Res 6:72–77

    Article  PubMed  Google Scholar 

  23. Pandit N, Gonen M, Krug L, Larson SM (2003) Prognostic value of [18F]FDG-PET imaging in small cell lung cancer. Eur J Nucl Med Mol Imaging 30:78–84

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Ludwig Institute Oncology Unit, Austin Health, Heidelberg, Australia

    Arun Azad, Fiona Chionh, Shane White & Paul L. Mitchell

  2. Centre for Positron Emission Tomography, Austin Health, Melbourne, Australia

    Andrew M. Scott, Szeting T. Lee & Sam U. Berlangieri

  3. Department of Medicine, University of Melbourne, Austin Health, Melbourne, Australia

    Andrew M. Scott, Szeting T. Lee, Sam U. Berlangieri, Shane White & Paul L. Mitchell

  4. Ludwig Institute for Cancer Research, Austin Health, 145-163 Studley Rd, Heidelberg, Victoria, Australia, 3084

    Andrew M. Scott & Szeting T. Lee

Authors
  1. Arun Azad
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  2. Fiona Chionh
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  3. Andrew M. Scott
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  4. Szeting T. Lee
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  5. Sam U. Berlangieri
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  6. Shane White
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  7. Paul L. Mitchell
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Corresponding author

Correspondence to Arun Azad.

Additional information

Significance of this work: our manuscript is notable for the fact that we are the first group to demonstrate the impact of PET on the prognostic stratification of newly diagnosed SCLC.

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Azad, A., Chionh, F., Scott, A.M. et al. High Impact of 18F-FDG-PET on Management and Prognostic Stratification of Newly Diagnosed Small Cell Lung Cancer. Mol Imaging Biol 12, 443–451 (2010). https://doi.org/10.1007/s11307-009-0295-z

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  • DOI: https://doi.org/10.1007/s11307-009-0295-z

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