Predictive value of 18F-FDG PET/CT for evaluating the response to hypofractionated radiotherapy combined with PD-1 blockade in non-small cell lung cancer

Shan Tang; Yan Zhang; Yunfei Li; Yan Zhang; Yuke Xu; Haoyuan Ding; Yue Chen; Peirong Ren; Hua Ye; Shaozhi Fu; Sheng Lin

doi:10.3389/fimmu.2023.1034416

Predictive value of ¹⁸F-FDG PET/CT for evaluating the response to hypofractionated radiotherapy combined with PD-1 blockade in non-small cell lung cancer

Front Immunol. 2023 Feb 13:14:1034416. doi: 10.3389/fimmu.2023.1034416. eCollection 2023.

Authors

Shan Tang^{1

2}, Yan Zhang³, Yunfei Li¹, Yan Zhang⁴, Yuke Xu⁵, Haoyuan Ding⁴, Yue Chen⁴, Peirong Ren¹, Hua Ye¹, Shaozhi Fu¹, Sheng Lin¹

Affiliations

¹ Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
² Department of Oncology, The First People's Hospital of Guangyuan, Guangyuan, China.
³ Department of Oncology, The People's Hospital of Luzhou, Luzhou, China.
⁴ Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
⁵ Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.

Abstract

Purpose: This retrospective study aimed to investigate ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG)-positron emission tomography/computed tomography (PET/CT) as a predictor of response to hypofractionated radiotherapy (HFRT) combined with programmed cell death-1 (PD-1) blockade for lung cancer.

Methods: We included 41 patients with advanced non-small cell lung cancer (NSCLC) in this study. PET/CT was performed before (SCAN-0) and one month (SCAN-1), three months (SCAN-2), and six months (SCAN-3) after treatment. Using the European Organization for Research and Treatment of Cancer 1999 criteria and PET response criteria in solid tumors, treatment responses were classified as complete metabolic response (CMR), partial metabolic response (PMR), stable metabolic disease (SMD), or progressive metabolic disease (PMD). Patients were further categorized as those with metabolic benefits (MB; SMD, PMR, and CMR) and those without MBs (NO-MB; PMD). We analyzed the prognosis and overall survival (OS) of patients with new visceral/bone lesions during treatment. Based on the findings, we generated a nomogram to predict survival. Receiver operating characteristics and calibration curves were used to evaluate the accuracy of the prediction model.

Results: The mean OS based on SCANs 1, 2, and 3 was significantly higher in patients with MB and those without new visceral/bone lesions. The prediction nomogram for survival had a high area under the curve and a high predictive value based on the receiver operating characteristics and calibration curves.

Conclusion: ¹⁸FDG-PET/CT has the potential to predict the outcomes of HFRT combined with PD-1 blockade in NSCLC. Therefore, we recommend using a nomogram to predict patient survival.

Keywords: 18F-FDG PET/CT; NSCLC; PD-1 blockade; hypofractionated radiotherapy; predictive value.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Bone Diseases*
Carcinoma, Non-Small-Cell Lung* / diagnostic imaging
Carcinoma, Non-Small-Cell Lung* / radiotherapy
Fluorodeoxyglucose F18
Humans
Hydrolases
Lung Neoplasms* / diagnostic imaging
Lung Neoplasms* / radiotherapy
Metabolic Diseases*
Positron Emission Tomography Computed Tomography
Programmed Cell Death 1 Receptor
Retrospective Studies

Substances

Fluorodeoxyglucose F18
Programmed Cell Death 1 Receptor
Hydrolases

Grants and funding

This work was supported by grants from the National Natural Science Foundation of China (no. 81201682), Scientific Research Foundation of the Luzhou Science and Technology Bureau (no. 2016LZXNYD-J05), and Southwest Medical University Foundation (No. 201617).