Pretreatment metabolic parameters measured by 18F-FDG-PET to predict the outcome of first-line chemotherapy in extensive-stage small-cell lung cancer

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Abstract

Objective

Patients’ pretreatment metabolic burden, as measured by radiotracer fluorine-18 fluorodeoxyglucose (18F-FDG) PET/computed tomography (CT), has been shown to predict treatment outcome in various malignancies. However, its predictive role in extensive-stage small cell lung cancer (SCLC) has not been definitively determined. This retrospective study investigated the viability of using common pretreatment metabolic parameters, obtained through 18F-FDG-PET/CT, to predict outcomes of first-line chemotherapy in extensive-stage SCLC.

Participants and methods

The study population comprised 154 consecutive patients with extensive-stage SCLC who underwent a pretreatment 18F-FDG-PET/CT scan and received standard first-line chemotherapy between January 2011 and December 2015.

Results

Ten (6.5%) and 66 (42.9%) patients achieved a complete or a partial response, respectively (considered an objective response); 35 (22.7%) and 43 (27.9%) experienced stable or progressive disease. The metabolic tumor volume (MTV) was a significant factor for predicting an objective response. For predicting disease control (objective response or stable disease), MTV and total lesion glycolysis (TLG) were nonindependent factors.

Conclusion

Greater MTV and TLG could indicate a poorer response to first-line chemotherapy for patients with extensive-stage SCLC, but the predictive efficiency was not high enough for routine reliance. For patients who are not suitable to receive first-line chemotherapy, MTV and TLG may help guide clinical decisions.

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