Total Lesion Glycolysis Determined per RECIST 1.1 Criteria Predicts Survival in EGFR Mutation-Negative Patients With Advanced Lung Adenocarcinoma. (June 2015)

• Record Type: Journal Article
• Authors: Ho, Tsung-Ying; Chou, Pai-Chien; Yang, Cheng-Ta; Tsang, Ngan-Ming; Yen, Tzu-Chen
• Is Part Of: Clinical nuclear medicine. Volume 40:Number 6(2015)
• Publication Date: 2015-06
• Subjects: Nuclear medicine -- Periodicals; Radioisotope scanning -- Periodicals; Nuclear Medicine -- Periodicals; 616.07575
• DOI: 10.1097/RLU.0000000000000774
• Languages: English
• ISSNs: 0363-9762

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Objective</title> <p>The aim of this retrospective study was to investigate the clinical impact of <sup>18</sup>F-FDG PET in patients with advanced lung adenocarcinoma stratified according to the epidermal growth factor receptor (<italic>EGFR</italic>) mutation status.</p> </sec> <sec> <title>Patients and Methods</title> <p>A total of 56 patients with advanced lung adenocarcinoma were included in the study. Thirty-one patients (55%) were <italic>EGFR</italic> mutation-positive, whereas the remaining 25 (45%) participants tested negative for <italic>EGFR</italic> mutations. All of the patients underwent <sup>18</sup>F-FDG PET/CT for pretreatment planning. The main outcome measure was overall survival (OS) at 24 months. The following <sup>18</sup>F-FDG PET/CT-derived variables were tested for their associations with OS: main tumor SUV<sub>max</sub>, main tumor total lesion glycolysis, and target lesions TLG determined per RECIST (Response Evaluation Criteria In Solid Tumors) 1.1 criteria (TLG<sub>RECIST</sub>). We also investigated the clinical characteristics in relation to OS and <italic>EGFR</italic> mutation status.</p> </sec> <sec> <title>Results</title> <p>In <italic>EGFR</italic> mutation-positive patients, neither the clinical characteristics nor <sup>18</sup>F-FDG PET/CT-derived parameters were significantly associated with OS. In contrast, univariate analysis identified male sex, a positive history of smoking, and TLG<sub>RECIST</sub> greater than or equal to 412 g as adverse prognostic factors for OS in <italic>EGFR</italic> mutation-negative patients. After adjustment for potential confounders in multivariate analysis, TLG<sub>RECIST</sub> was the sole independent predictor of OS in this subgroup.</p> </sec> <sec> <title>Conclusions</title> <p>TLG determined per RECIST 1.1 criteria is an independent predictor of OS in <italic>EGFR</italic> mutation-negative patients with advanced lung adenocarcinoma. Further studies are needed to investigate whether this parameter may be a promising tool for stratifying such patients for risk-adapted therapies.</p> </sec> </abstract>