USE OF PET/CT FOR RADIOTHERAPY PLANNING OF STAGE III NON-SMALL CELL LUNG CANCER (NSCLC) IN LOW AND MIDDLE INCOME COUNTRIES (PERTAIN - PET RADIOTHERAPY INTERNATIONAL). PRELIMINARY UNINSTITUTIONAL RESULTS

Introduction: For accurate staging and adequate patient selection for curative treatment of NSCLC, the use of 18F-FDG PET/CT has been shown to be superior to CT alone. Also, it has an important impact on radiotherapy (RT) planning, where a significant reduction in interobserver variation in the target volume delineation is observed. Objective: To determine the impact of the use of PET/CT on RT planning on overall and disease-free survival rates after two years in stage III NSCLC patients receiving radiochemotherapy (RCT) with curative intent. We present the uninstitutional partial Results: Method: Multicenter study with a retrospective and prospective component including patients with stage III NSCLC (AJCC 7th ed) submitted to RCT. Initially, the PET/CT equipment was accredited and calibrated with the RT planning system. Simultaneously, a training for PET/CT based target delineation was performed. In the retrospective group, the inclusion of patients submitted to neoadjuvant chemotherapy followed by RT was allowed, in addition to those submitted to concomitant RCT. All patients included in the prospective phase underwent PET/CT in the treatment position and received concomitant RCT. Total sample size was based on a 30% two-year survival rate in the retrospective cohort and a 5-7% increase with the use of PET/CT for the prospective cohort. With a power of 0.9 and a 95% confidence interval, 519 pts (50 patients per participating institution) were estimated. Results: Only the results of patients who received concomitant RCT treated at our institution are presented. In the retrospective phase, 23 patients treated from May 2010 to December 2013 were included and 25 patients were recruited between February 2016 and December 2018 in the prospective phase. The patients characteristics between the groups were similar, with a mean age of 60 and 58 years, respectively, majority of male, adenocarcinoma and stage IIIB. Two-year progressionfree and overall survival rates were 22.6% and 51.5% for the retrospective group (median follow-up of 25 months) and 64.0% and 52.8% for the prospective group (median follow-up of 18 months), respectively (p> 0.05). Conclusion: The use of PET/CT in the contouring and planning of RT had no significant impact on the two-year survival in this group of patients. However, the potential of this strategy should be better analyzed with greater follow-up of the prospective group. The international study is ongoing.

 

MissingLinkText

Die Autoren geben an, dass kein Interessenkonflikt besteht.

Publikationsverlauf

Artikel online veröffentlicht:
23. Oktober 2019