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P-192 Post-treatment FDG-PET predicts prognosis of lung cancer patients treated with radiation therapy
Poster Session I /Radiotherapy
El192 P
Post-treatment FDG-PET predicts prognosis of lung cancer patients treated with radiation therapy
Yuko Nakavama’, Yoshizumi Kitamoto’, Hitoshi Ishikawa’, Masatoshi Hasegawa’, Takashi Nakano’, Hideo Niibe’, Kazushige Hayakawa”. ‘De@. of Radiology & Radiation Oncology Gunma University Maebashi, Japan; 2 Dept. of Radiology Kifazato University, Sagamihara, Japan
Purpose: We investigated whether FDG uptake at the primary site after radiation therapy would be a prognostic factor of local recurrence or not in lung cancer patients. Methods: Twelve lung cancer patients treated with definitive radiation therapy were included in the study. All patients underwent FDG-PET at the initiation of treatment and around 4 weeks after completion of radiation therapy. The median follow-up was 14 months (ranged from 8 to 22 months). Standard uptake value (SUV) was used as an index of the FDG uptake. Results: Among 12 patients, 6 patients had local recurrence. The SUVs at the initiation of radiation therapy were over 2.5 in all patients. After treatment, five out of 6 patients showed decrease in the SUVs at primary sites below 2.0 in contrast to only 1 of 6 patients with local recurrence. When a value of 2.0 was used as the SUV cut-off, both sensitivity and specificity were 83% (5/6), respectively. No patient had FDG uptake at the area of radiation pneumonia, confusing assessment of tumor response. Conclusion: These results indicate that recommended interval between FDG-PET and completion of radiation therapy is around 4 weeks, and FDG uptake after radiation therapy would have a prognostic significance in patients with lung cancer.
P 193 El
Radiofrequency Lung Cancer
s139
Ablation for Local Control of Primary
Ernest M. Scalzetti, Robert G. Dixon, Kenneth D. Murphy, Leslie A. Kohman, Stephen L. Graziano. SUNY Upstate Medical University, Syracuse, USA
Purpose: Percutaneous radiofrequency ablation (RFA) of pulmonary neoplasia is a relatively new treatment modality. We evaluated the effectiveness of RFA in achieving local control in patients with primary lung cancers. Materials and Methods: A total of twelve (n=12) patients with primary nonsmall cell lung carcinoma (NSCLC) were enrolled in the retrospective study. All patients met the following criteria: 1) Clinical stage 1 NSCLC, 2) Not candidates for, or refusal of, surgery and radiation therapy, and 3) Life expectancy greater than 6 months. Radiofrequency ablation was performed using the Radiotherapeutics LeVeen needle-electrode (MediTechBoston Scientific) under computed tomographic guidance with intent to cure. A total of 12 lesions in 12 patients were treated, with a mean size of 2.6 cm, (range 1.5 - 5.7 cm). None of the patients received other forms of therapy. Follow-up consisted of clinical evaluation and imaging (computed tomography, positron emission tomography). Results: The technical success rate of the procedure was 100%. Pneumothorax occurred in 6/12 patients. However, only 3/12 patients required chest tube placement; the others were managed conservatively. There was no clinically significant pulmonary hemorrhage. The mean follow-up was 13 months (range 1 - 31 months). There were 3 deaths, all within 5 months of the procedure. At follow-up in the remaining patients, local stability or regression was demonstrated in 8/12. However, one patient demonstrated local progression, and development of distant metastases was seen in two others. Disease-free survival is 50% at this point, and all-cause mortality is 25%. Conclusions: RFA of NSCLC demonstrates local control in most patients, in short-term follow-up. Longer-term studies are warranted.
El192 P
Post-treatment FDG-PET predicts prognosis of lung cancer patients treated with radiation therapy
Yuko Nakavama’, Yoshizumi Kitamoto’, Hitoshi Ishikawa’, Masatoshi Hasegawa’, Takashi Nakano’, Hideo Niibe’, Kazushige Hayakawa”. ‘De@. of Radiology & Radiation Oncology Gunma University Maebashi, Japan; 2 Dept. of Radiology Kifazato University, Sagamihara, Japan
Purpose: We investigated whether FDG uptake at the primary site after radiation therapy would be a prognostic factor of local recurrence or not in lung cancer patients. Methods: Twelve lung cancer patients treated with definitive radiation therapy were included in the study. All patients underwent FDG-PET at the initiation of treatment and around 4 weeks after completion of radiation therapy. The median follow-up was 14 months (ranged from 8 to 22 months). Standard uptake value (SUV) was used as an index of the FDG uptake. Results: Among 12 patients, 6 patients had local recurrence. The SUVs at the initiation of radiation therapy were over 2.5 in all patients. After treatment, five out of 6 patients showed decrease in the SUVs at primary sites below 2.0 in contrast to only 1 of 6 patients with local recurrence. When a value of 2.0 was used as the SUV cut-off, both sensitivity and specificity were 83% (5/6), respectively. No patient had FDG uptake at the area of radiation pneumonia, confusing assessment of tumor response. Conclusion: These results indicate that recommended interval between FDG-PET and completion of radiation therapy is around 4 weeks, and FDG uptake after radiation therapy would have a prognostic significance in patients with lung cancer.
P 193 El
Radiofrequency Lung Cancer
s139
Ablation for Local Control of Primary
Ernest M. Scalzetti, Robert G. Dixon, Kenneth D. Murphy, Leslie A. Kohman, Stephen L. Graziano. SUNY Upstate Medical University, Syracuse, USA
Purpose: Percutaneous radiofrequency ablation (RFA) of pulmonary neoplasia is a relatively new treatment modality. We evaluated the effectiveness of RFA in achieving local control in patients with primary lung cancers. Materials and Methods: A total of twelve (n=12) patients with primary nonsmall cell lung carcinoma (NSCLC) were enrolled in the retrospective study. All patients met the following criteria: 1) Clinical stage 1 NSCLC, 2) Not candidates for, or refusal of, surgery and radiation therapy, and 3) Life expectancy greater than 6 months. Radiofrequency ablation was performed using the Radiotherapeutics LeVeen needle-electrode (MediTechBoston Scientific) under computed tomographic guidance with intent to cure. A total of 12 lesions in 12 patients were treated, with a mean size of 2.6 cm, (range 1.5 - 5.7 cm). None of the patients received other forms of therapy. Follow-up consisted of clinical evaluation and imaging (computed tomography, positron emission tomography). Results: The technical success rate of the procedure was 100%. Pneumothorax occurred in 6/12 patients. However, only 3/12 patients required chest tube placement; the others were managed conservatively. There was no clinically significant pulmonary hemorrhage. The mean follow-up was 13 months (range 1 - 31 months). There were 3 deaths, all within 5 months of the procedure. At follow-up in the remaining patients, local stability or regression was demonstrated in 8/12. However, one patient demonstrated local progression, and development of distant metastases was seen in two others. Disease-free survival is 50% at this point, and all-cause mortality is 25%. Conclusions: RFA of NSCLC demonstrates local control in most patients, in short-term follow-up. Longer-term studies are warranted.