A secondary analysis of FDG spatio-temporal consistency in the randomized phase II PET-boost trial in stage II–III NSCLC

Research output: Contribution to journalJournal articleResearchpeer-review

  • Matthew La Fontaine
  • Wouter Vogel
  • Judi van Diessen
  • Wouter van Elmpt
  • Bart Reymen
  • Persson, Gitte
  • Gunnar Westman
  • Dirk De Ruysscher
  • José Belderbos
  • Jan-Jakob Sonke

Purpose: FDG-PET scans have shown spatial consistency in NSCLC patients before and following chemoradiotherapy, implying radioresistance. We hypothesized that patients, who received FDG-PET redistributed dose painting, would demonstrate reduced spatial consistency when compared to registered patients or to escalated dose treatment. Methods: Stage II–IIIB, inoperable NSCLC patients were randomized in a phase II trial (NCT01024829) to (chemo)radiotherapy of either homogeneous boosting to the primary tumor, or redistributed inhomogeneous boosting to the GTV subvolume (FDG-SUV > 50% SUVmax). Patients who could not be boosted (≥72 Gy) received 66 Gy in 24 fractions. Spatial consistency of pre-treatment and post-treatment (3 months) FDG-PET scans was measured by various overlap fraction thresholds. Results: 66/82 patients analyzed received randomized treatment in the trial. Thresholds of 50% SUVmax pre-treatment and 70% SUVmax post-treatment yielded a median overlap fraction of 0.63 [interquartile range: 0.15–0.93], with similar results for other thresholds. No significant differences were found among overlap fractions of the treatment groups. A high incidence of FDG-uptake in normal lung (grade-1 pneumonitis: 73%) was found post-treatment. Conclusion: FDG redistributed boosting did not reduce FDG spatial consistency from pre-treatment to post-treatment, which was highly variable among patients. The study found high numbers of patients with lung inflammation after treatment.

Original languageEnglish
JournalRadiotherapy and Oncology
Volume127
Issue number2
Pages (from-to)259-266
Number of pages8
ISSN0167-8140
DOIs
Publication statusPublished - 2018

Bibliographical note

Publisher Copyright:
© 2018 Elsevier B.V.

    Research areas

  • Dose escalation, Dose painting, FDG PET, Integrated boost, NSCLC

ID: 357367212