TY - JOUR
T1 - Delta Changes in [18F]FDG PET/CT Parameters Can Prognosticate Clinical Outcomes in Recurrent NSCLC Patients Who Have Undergone Reirradiation–Chemoimmunotherapy
AU - Grambozov, Brane
AU - Zamani-Siahkali, Nazanin
AU - Stana, Markus
AU - Beheshti, Mohsen
AU - Ruznic, Elvis
AU - Iskakova, Zarina
AU - Karner, Josef
AU - Zellinger, Barbara
AU - Gerum, Sabine
AU - Roeder, Falk
AU - Pirich, Christian
AU - Zehentmayr, Franz
N1 - Grambozov, Stana, Ruznic, Iskakova, Karner, Gerum, Roeder, Zehentmayr:
Department of Radiation Oncology, Paracelsus Medical University, SALK, Müllner Hauptstraße 48, A-5020 Salzburg, Austria;Zamani-Siahkali, Beheshti: Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, Paracelsus MedicalUniversity, SALK, A-5020 Salzburg, Austria; Zellinger: Institute of Pathology, Paracelsus Medical University, SALK, A-5020 Salzburg, Austria; Röder: RadART—Institute for Research and Development on Advanced Radiation Technologies, Paracelsus Medical University, A-5020 Salzburg, Austria; Pirich: Department of Nuclear Medicine, Paracelsus Medical University, SALK, A-5020 Salzburg, Austria
PY - 2025/7/31
Y1 - 2025/7/31
N2 - Background and Purpose: Stratification based on specific image biomarkers applicable in clinical settings could help optimize treatment outcomes for recurrent non-small cell lung cancer patients. For this purpose, we aimed to determine the clinical impact of positive delta changes (any difference above zero > 0) between baseline [F-18]FDG PET/CT metrics before the first treatment course and reirradiation. Material/Methods: Forty-seven patients who underwent thoracic reirradiation with curative intent at our institute between 2013 and 2021 met the inclusion criteria. All patients had histologically verified NSCLC, ECOG (Eastern Cooperative Oncology Group) <= 2, and underwent [F-18]FDG PET/CT for initial staging and re-staging before primary radiotherapy and reirradiation, respectively. The time interval between radiation treatments was at least nine months. Quantitative metabolic volume and intensity parameters were measured before first irradiation and before reirradiation, and the difference above zero (>0; delta change) between them was statistically correlated to locoregional control (LRC), progression-free survival (PFS), and overall survival (OS). Results: Patients were followed for a median time of 33 months after reirradiation. The median OS was 21.8 months (95%-CI: 16.3-27.3), the median PFS was 12 months (95%-CI: 6.7-17.3), and the median LRC was 13 months (95%-CI: 9.0-17.0). Multivariate analysis revealed that the delta changes in SULpeak, SUVmax, and SULmax of the lymph nodes significantly impacted OS (SULpeak p = 0.017; SUVmax p = 0.006; SULmax p = 0.006), PFS (SULpeak p = 0.010; SUVmax p = 0.009; SULmax p = 0.009), and LRC (SULpeak p < 0.001; SUVmax p = 0.003; SULmax p = 0.003). Conclusions: Delta changes in SULpeak, SUVmax, and SULmax of the metastatic lymph nodes significantly impacted all clinical endpoints (OS, PFS and LRC) in recurrent NSCLC patients treated with reirradiation. Hence, these imaging biomarkers could be helpful with regard to patient selection in this challenging clinical situation.
AB - Background and Purpose: Stratification based on specific image biomarkers applicable in clinical settings could help optimize treatment outcomes for recurrent non-small cell lung cancer patients. For this purpose, we aimed to determine the clinical impact of positive delta changes (any difference above zero > 0) between baseline [F-18]FDG PET/CT metrics before the first treatment course and reirradiation. Material/Methods: Forty-seven patients who underwent thoracic reirradiation with curative intent at our institute between 2013 and 2021 met the inclusion criteria. All patients had histologically verified NSCLC, ECOG (Eastern Cooperative Oncology Group) <= 2, and underwent [F-18]FDG PET/CT for initial staging and re-staging before primary radiotherapy and reirradiation, respectively. The time interval between radiation treatments was at least nine months. Quantitative metabolic volume and intensity parameters were measured before first irradiation and before reirradiation, and the difference above zero (>0; delta change) between them was statistically correlated to locoregional control (LRC), progression-free survival (PFS), and overall survival (OS). Results: Patients were followed for a median time of 33 months after reirradiation. The median OS was 21.8 months (95%-CI: 16.3-27.3), the median PFS was 12 months (95%-CI: 6.7-17.3), and the median LRC was 13 months (95%-CI: 9.0-17.0). Multivariate analysis revealed that the delta changes in SULpeak, SUVmax, and SULmax of the lymph nodes significantly impacted OS (SULpeak p = 0.017; SUVmax p = 0.006; SULmax p = 0.006), PFS (SULpeak p = 0.010; SUVmax p = 0.009; SULmax p = 0.009), and LRC (SULpeak p < 0.001; SUVmax p = 0.003; SULmax p = 0.003). Conclusions: Delta changes in SULpeak, SUVmax, and SULmax of the metastatic lymph nodes significantly impacted all clinical endpoints (OS, PFS and LRC) in recurrent NSCLC patients treated with reirradiation. Hence, these imaging biomarkers could be helpful with regard to patient selection in this challenging clinical situation.
KW - 18f-fdg-pet-ct
KW - Image biomarkers
KW - Non-small cell lung cancer
KW - Reirradiation
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=pmu_pure&SrcAuth=WosAPI&KeyUT=WOS:001559764400001&DestLinkType=FullRecord&DestApp=WOS_CPL
U2 - 10.3390/biomedicines13081866
DO - 10.3390/biomedicines13081866
M3 - Original Article
C2 - 40868121
SN - 2227-9059
VL - 13
JO - BIOMEDICINES
JF - BIOMEDICINES
IS - 8
M1 - 1866
ER -