Nguyen, Xuan Canh (2013) PROGNOSTIC VALUE OF FDG UPTAKE OF PRIMARY TUMOR AND METASTATIC LESIONS IN ADVANCED NON-SMALL CELL LUNG CANCER. [Tesi di dottorato]

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THESIS ON FDG PROGNOSIS - NSCLC - NGUYEN XUAN CANH - 15-03-2013.pdf

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Tipologia del documento: Tesi di dottorato
Lingua: English
Titolo: PROGNOSTIC VALUE OF FDG UPTAKE OF PRIMARY TUMOR AND METASTATIC LESIONS IN ADVANCED NON-SMALL CELL LUNG CANCER
Autori:
AutoreEmail
Nguyen, Xuan Canhnxcanh2000@yahoo.com
Data: 16 Marzo 2013
Numero di pagine: 64
Istituzione: Università degli Studi di Napoli Federico II
Dipartimento: Scienze Biomediche Avanzate
Scuola di dottorato: Scienze biomorfologiche e chirurgiche
Dottorato: Imaging molecolare
Ciclo di dottorato: 25
Coordinatore del Corso di dottorato:
nomeemail
Salvatore, Marcomarsalva@unina.it
Tutor:
nomeemail
Maurea, Simonemaurea@unina.it
Data: 16 Marzo 2013
Numero di pagine: 64
Parole chiave: Positron emission tomography / computed tomography (PET/CT), 2-deoxy-2-[18F]-fluoro-D-glucose (18F-FDG or FDG), non-small cell lung cancer (NSCLC), Maximum standardized uptake value (maxSUV)
Settori scientifico-disciplinari del MIUR: Area 06 - Scienze mediche > MED/36 - Diagnostica per immagini e radioterapia
Depositato il: 04 Apr 2013 09:51
Ultima modifica: 31 Dic 2016 02:00
URI: http://www.fedoa.unina.it/id/eprint/9073

Abstract

Purpose: To assess the prognostic value of metabolic tumor burden as sumaxSUV measured by sum of the maxSUVs of primary tumor, metastatic lymph nodes and metastatic lesions per each organ on FDG-PET/CT in patients with advanced NSCLC. Materials and methods: Eighty three patients with advanced NSCLC were enrolled. Seventeen patients had stage IIIA, 21 had stage IIIB and 45 had stage IV. SumaxSUV, maxSUV of primary tumor (maxSUVpt), maxSUV of whole body tumors (maxSUVwb), age, gender, tumor-cell type, T stage, N stage, overall stage, primary tumor size, specific treatment were analyzed for correlation with overall survival. Median follow-up duration was 13 months. Results: Fifty (60.2%) of the 83 patients were dead during a median follow-up time of 11 months and 33 patients (39.8%) were alive with a median follow-up time of 15 months. Univariate analysis revealed that overall survival was significantly correlated with sumaxSUV (≥35 vs. <35, p = 0.004), T stage (T4 vs. T1-T3, p = 0.025), overall stage (IV vs. III, p = 0.002), gender (male vs. female, p = 0.029) and specific treatment (no vs. yes, p = 0.011). Multivariate analysis identified sumaxSUV, T stage, gender and specific treatment as independent prognostic indicators in advanced NSCLC. Patients with a sumaxSUV of  35 were 1.921 times more likely to die from NSCLC than those with a sumaxSUV of ≤35 (p = 0.047). The median survival time was 14 months for patients with sumaxSUV 35 compared to 20 months for those with sumaxSUV <35. In patients with metastatic NSCLC, sumaxSUV with cut-off of 35 was much more significant for survival prognosis (p = 0.021). Conclusion: SumaxSUV is a new prognostic measure, independent of tumor stage, gender and specific treatment in advanced NSCLC. SumaxSUV may be better than maxSUVpt and maxSUVwb in prediction of survival in advanced NSCLC. A large prospective cohort study is necessary to validate these results.

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