Early lesion-specific 18F-FDG PET response to chemotherapy predicts time to lesion progression in locally advanced non-small cell lung cancer

Lotte Nygård; Ivan Richter Vogelius; Barbara M Fischer; Thomas L. Klausen; Seppo W Langer; Markus N Lonsdale; Gitte F Persson; Søren M Bentzen

doi:10.1016/j.radonc.2016.01.009

Early lesion-specific ¹⁸F-FDG PET response to chemotherapy predicts time to lesion progression in locally advanced non-small cell lung cancer

Lotte Nygård, Ivan Richter Vogelius, Barbara M Fischer, Thomas L. Klausen, Seppo W Langer, Markus N Lonsdale, Gitte F Persson, Søren M Bentzen

9 Citations (Scopus)

Abstract

Background and purpose We hypothesize that the lesion-to-lesion variability in FDG-PET response after one cycle of chemotherapy for NSCLC in an individual patient may inform radiation dose redistribution. To test this hypothesis, we investigate if time to lesion-progression in patients with multiple lesions is dependent on lesion-specific response to chemotherapy. Materials and methods We analyzed 81 patients with 184 lesions referred to curative chemo-radiotherapy for NSCLC 2010-2012. ¹⁸F-FDG PET scans were performed at diagnosis and after one series of chemotherapy. Response of each lesion was assessed as the change in FDG peak standardized uptake value. Variance of lesion response was compared within and between patients. Time to progression for each lesion was analyzed using the Kaplan-Meier method and the Cox proportional hazards model. Results Within-patient variability in lesion responses was of the same magnitude as the between-patient variability. Lesion-specific time to progression was longer in lesions with a better response (log-rank p = 0.038). Nodal lesions had a much lower risk of progression than T-site lesions (HR = 0.09, p < 0.0001). Conclusions Recording an overall patient response involves a loss of biological information on heterogeneity between lesions. Poor lesion-specific response after one cycle chemotherapy may identify lesions that would benefit from an individualized radiotherapy strategy.

Original language	English
Journal	Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
Volume	118
Issue number	3
Pages (from-to)	460-464
Number of pages	5
ISSN	0167-8140
DOIs	https://doi.org/10.1016/j.radonc.2016.01.009
Publication status	Published - 1 Mar 2016

Keywords

Adult
Aged
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung
Chemoradiotherapy
Disease Progression
Female
Fluorodeoxyglucose F18
Humans
Lung Neoplasms
Male
Middle Aged
Positron-Emission Tomography
Proportional Hazards Models
Radiopharmaceuticals
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.radonc.2016.01.009

Cite this

Nygård, L., Vogelius, I. R., Fischer, B. M., Klausen, T. L., Langer, S. W., Lonsdale, M. N., Persson, G. F., & Bentzen, S. M. (2016). Early lesion-specific ¹⁸F-FDG PET response to chemotherapy predicts time to lesion progression in locally advanced non-small cell lung cancer. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 118(3), 460-464. https://doi.org/10.1016/j.radonc.2016.01.009

Early lesion-specific ¹⁸F-FDG PET response to chemotherapy predicts time to lesion progression in locally advanced non-small cell lung cancer. / Nygård, Lotte; Vogelius, Ivan Richter; Fischer, Barbara M et al.
In: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, Vol. 118, No. 3, 01.03.2016, p. 460-464.

Research output: Contribution to journal › Journal article › Research › peer-review

Nygård, L, Vogelius, IR, Fischer, BM, Klausen, TL, Langer, SW, Lonsdale, MN, Persson, GF & Bentzen, SM 2016, 'Early lesion-specific ¹⁸F-FDG PET response to chemotherapy predicts time to lesion progression in locally advanced non-small cell lung cancer', Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, vol. 118, no. 3, pp. 460-464. https://doi.org/10.1016/j.radonc.2016.01.009

Nygård L, Vogelius IR, Fischer BM, Klausen TL, Langer SW, Lonsdale MN et al. Early lesion-specific ¹⁸F-FDG PET response to chemotherapy predicts time to lesion progression in locally advanced non-small cell lung cancer. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. 2016 Mar 1;118(3):460-464. doi: 10.1016/j.radonc.2016.01.009

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abstract = "Background and purpose We hypothesize that the lesion-to-lesion variability in FDG-PET response after one cycle of chemotherapy for NSCLC in an individual patient may inform radiation dose redistribution. To test this hypothesis, we investigate if time to lesion-progression in patients with multiple lesions is dependent on lesion-specific response to chemotherapy. Materials and methods We analyzed 81 patients with 184 lesions referred to curative chemo-radiotherapy for NSCLC 2010-2012. 18F-FDG PET scans were performed at diagnosis and after one series of chemotherapy. Response of each lesion was assessed as the change in FDG peak standardized uptake value. Variance of lesion response was compared within and between patients. Time to progression for each lesion was analyzed using the Kaplan-Meier method and the Cox proportional hazards model. Results Within-patient variability in lesion responses was of the same magnitude as the between-patient variability. Lesion-specific time to progression was longer in lesions with a better response (log-rank p = 0.038). Nodal lesions had a much lower risk of progression than T-site lesions (HR = 0.09, p < 0.0001). Conclusions Recording an overall patient response involves a loss of biological information on heterogeneity between lesions. Poor lesion-specific response after one cycle chemotherapy may identify lesions that would benefit from an individualized radiotherapy strategy.",

keywords = "Adult, Aged, Aged, 80 and over, Carcinoma, Non-Small-Cell Lung, Chemoradiotherapy, Disease Progression, Female, Fluorodeoxyglucose F18, Humans, Lung Neoplasms, Male, Middle Aged, Positron-Emission Tomography, Proportional Hazards Models, Radiopharmaceuticals, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't",

author = "Lotte Nyg{\aa}rd and Vogelius, {Ivan Richter} and Fischer, {Barbara M} and Klausen, {Thomas L.} and Langer, {Seppo W} and Lonsdale, {Markus N} and Persson, {Gitte F} and Bentzen, {S{\o}ren M}",

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doi = "10.1016/j.radonc.2016.01.009",

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T1 - Early lesion-specific 18F-FDG PET response to chemotherapy predicts time to lesion progression in locally advanced non-small cell lung cancer

AU - Nygård, Lotte

AU - Vogelius, Ivan Richter

AU - Fischer, Barbara M

AU - Klausen, Thomas L.

AU - Langer, Seppo W

AU - Lonsdale, Markus N

AU - Persson, Gitte F

AU - Bentzen, Søren M

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Background and purpose We hypothesize that the lesion-to-lesion variability in FDG-PET response after one cycle of chemotherapy for NSCLC in an individual patient may inform radiation dose redistribution. To test this hypothesis, we investigate if time to lesion-progression in patients with multiple lesions is dependent on lesion-specific response to chemotherapy. Materials and methods We analyzed 81 patients with 184 lesions referred to curative chemo-radiotherapy for NSCLC 2010-2012. 18F-FDG PET scans were performed at diagnosis and after one series of chemotherapy. Response of each lesion was assessed as the change in FDG peak standardized uptake value. Variance of lesion response was compared within and between patients. Time to progression for each lesion was analyzed using the Kaplan-Meier method and the Cox proportional hazards model. Results Within-patient variability in lesion responses was of the same magnitude as the between-patient variability. Lesion-specific time to progression was longer in lesions with a better response (log-rank p = 0.038). Nodal lesions had a much lower risk of progression than T-site lesions (HR = 0.09, p < 0.0001). Conclusions Recording an overall patient response involves a loss of biological information on heterogeneity between lesions. Poor lesion-specific response after one cycle chemotherapy may identify lesions that would benefit from an individualized radiotherapy strategy.

AB - Background and purpose We hypothesize that the lesion-to-lesion variability in FDG-PET response after one cycle of chemotherapy for NSCLC in an individual patient may inform radiation dose redistribution. To test this hypothesis, we investigate if time to lesion-progression in patients with multiple lesions is dependent on lesion-specific response to chemotherapy. Materials and methods We analyzed 81 patients with 184 lesions referred to curative chemo-radiotherapy for NSCLC 2010-2012. 18F-FDG PET scans were performed at diagnosis and after one series of chemotherapy. Response of each lesion was assessed as the change in FDG peak standardized uptake value. Variance of lesion response was compared within and between patients. Time to progression for each lesion was analyzed using the Kaplan-Meier method and the Cox proportional hazards model. Results Within-patient variability in lesion responses was of the same magnitude as the between-patient variability. Lesion-specific time to progression was longer in lesions with a better response (log-rank p = 0.038). Nodal lesions had a much lower risk of progression than T-site lesions (HR = 0.09, p < 0.0001). Conclusions Recording an overall patient response involves a loss of biological information on heterogeneity between lesions. Poor lesion-specific response after one cycle chemotherapy may identify lesions that would benefit from an individualized radiotherapy strategy.

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KW - Lung Neoplasms

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KW - Middle Aged

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