A secondary analysis of FDG spatio-temporal consistency in the randomized phase II PET-boost trial in stage II–III NSCLC

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Matthew La Fontaine
  • Wouter Vogel
  • Judi van Diessen
  • Wouter van Elmpt
  • Bart Reymen
  • Persson, Gitte
  • Gunnar Westman
  • Dirk De Ruysscher
  • José Belderbos
  • Jan-Jakob Sonke

Purpose: FDG-PET scans have shown spatial consistency in NSCLC patients before and following chemoradiotherapy, implying radioresistance. We hypothesized that patients, who received FDG-PET redistributed dose painting, would demonstrate reduced spatial consistency when compared to registered patients or to escalated dose treatment. Methods: Stage II–IIIB, inoperable NSCLC patients were randomized in a phase II trial (NCT01024829) to (chemo)radiotherapy of either homogeneous boosting to the primary tumor, or redistributed inhomogeneous boosting to the GTV subvolume (FDG-SUV > 50% SUVmax). Patients who could not be boosted (≥72 Gy) received 66 Gy in 24 fractions. Spatial consistency of pre-treatment and post-treatment (3 months) FDG-PET scans was measured by various overlap fraction thresholds. Results: 66/82 patients analyzed received randomized treatment in the trial. Thresholds of 50% SUVmax pre-treatment and 70% SUVmax post-treatment yielded a median overlap fraction of 0.63 [interquartile range: 0.15–0.93], with similar results for other thresholds. No significant differences were found among overlap fractions of the treatment groups. A high incidence of FDG-uptake in normal lung (grade-1 pneumonitis: 73%) was found post-treatment. Conclusion: FDG redistributed boosting did not reduce FDG spatial consistency from pre-treatment to post-treatment, which was highly variable among patients. The study found high numbers of patients with lung inflammation after treatment.

OriginalsprogEngelsk
TidsskriftRadiotherapy and Oncology
Vol/bind127
Udgave nummer2
Sider (fra-til)259-266
Antal sider8
ISSN0167-8140
DOI
StatusUdgivet - 2018

Bibliografisk note

Funding Information:
This research was supported by the European Commission , 7th Framework Project Grant Agreement nr. 257144, ARTFORCE project; and the Dutch Cancer Society (project number 2010-4675). The sponsors had no involvement in study design, collection, analysis, or in the interpretation of the data. In addition, the authors would like to recognize Marianne Camille Aznar (Copenhagen), Gilles Defraene (Leuven), Aniek Even (Maastricht), and Maddalena Rossi (Amsterdam) for their efforts in the process of data collecting and transfer.

Publisher Copyright:
© 2018 Elsevier B.V.

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