The clinical impact of the sum of the maximum standardized uptake value on the pretreatment with F-FDG-PET/CT in small-cell lung cancer

Abstract

Objectives: The aim of this study was to investigate the clinical significance of the sum of the maximum standardized uptake value (sumSUVmax) on pretreatment positron emission tomography/computed tomography ((18)F-FDG-PET/CT) in newly diagnosed small-cell lung cancer (SCLC).

Methods: We retrospectively analyzed 145 SCLC patients from March 2005 to June 2013 who underwent pretreatment (18)F-FDG-PET/CT. The sumSUVmax was assessed in all malignant lesions up to a maximum of 5 lesions and a maximum of 2 lesions per organ according to RECIST 1.1.

Results: A significant difference was found between the low and high sumSUVmax groups (low vs. high sumSUVmax, 91.5 vs. 77.3%; p = 0.018) in the response rate (RR) following frontline platinum-based chemotherapy. The group with low sumSUVmax showed significantly better overall survival (OS; p < 0.001) as well as better progression-free survival (PFS; p < 0.001) compared with the group with high sumSUVmax. Moreover, multivariate analysis revealed that a high sumSUVmax alone was an independent poor prognostic factor for OS (hazard ratio 2.676; 95% confidence interval, 1.674-4.277; p < 0.001).

Conclusions: This study showed that the sumSUVmax adopted from RECIST 1.1 on pretreatment (18)F-FDG PET/CT was significantly correlated with response to treatment, OS, and PFS in patients with SCLC.