Morpho-metabolic Responses on Restaging 18-FDG-PET-CT-Scan Clearly Predict a Longer Time to Relapse in Patients With Locally Advanced Non-small Cell Lung Cancer Treated With Induction Chemo or Chemoradiation

Abstract

SESSION TITLE: Lung Cancer Posters IISESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: Half of non-small cell lung cancers are diagnosed in locally advanced stages (LA-NSCLC) and treated by combining chemotherapy, radiation (RT), and surgery (S). Induction chemo (iCT) and chemoradiation (iCRT) are at least as effective as adjuvant therapies are, and allow to infer survival predictions depending on the grade of response. The 18-FDG-PET-CT-Scan (PET) is slowly introducing in the evaluation of those responses. We analyzed the impact of changes in re-staging PET in the outcome of patients with LA-NSCLC treated with induction therapiesMETHODS: We retrospectively reviewed 55 patients with LA-NSCLC treated with platin-based iCT or iCRT followed by S or RT in our center from October-2004 to June-2012. In all of them, PET was performed immediately before and after the completion of induction therapies. The statistical impact of changes in the T size, T standardized uptake value (SUVmax), N stage, N SUVmax, and final N SUVmax over the risk of relapse, disease free survival (DFS), and overall survival (OS) was analyzedRESULTS: Our series was made up by 2 women and 53 men. Mean age was 66.8 years old (range 47-82). Fifteen patients were treated with platin-based iCRT and S; 17 with iCRT and consolidative RT; 14 with iCT and S; and 9 with iCT and RT. DFS was statistically longer when re-staging PET showed a reduction in T size (p= 0.000), T SUVmax (p= 0.001) (figure 1), N size (p= 0.004), and N SUVmax (p= 0.023). DFS was also proportional to final cN stage in PET (p= 0.000) (Figure 2). On the other hand, none of these variables statistically impact on OSCONCLUSIONS: PET responses are significantly related with a better DFS. No significant impact on OS can be biased by the small size of our sample.CLINICAL IMPLICATIONS: PET provides significant prognostic information after iCT or iCRT that could help to decide the most suitable consolidation treatment for patients with LA-NSCLCA.DISCLOSURE: Diego Marquez-Medina: Grant monies (from industry related sources): Llilly advisor, Grant monies (from industry related sources): Roche advisor, Grant monies (from industry related sources): Astra Zeneca speacher The following authors have nothing to disclose: Ariadna Gasol-Cudos, Antonio Martin-MarcoNo Product/Research Disclosure Information.