• Zachary D Horne, David A Clump, John A Vargo, Samir Shah, Sushil Beriwal, Steven A Burton, Annette E Quinn, Matthew J Schuchert, Rodney J Landreneau, Neil A Christie, James D Luketich, and Dwight E Heron.
• Department of Radiation Oncology, University of Pittsburgh Cancer Institute, 5230 Centre Ave, Pittsburgh PA 15232, USA. herond2@upmc.edu.
• Radiat Oncol. 2014 Jan 30; 9: 41.

BackgroundThis retrospective study aims to assess the usefulness of SUV(max) from FDG-PET imaging as a prognosticator for primary biopsy-proven stage I NSCLC treated with SBRT.MethodsThis study includes 95 patients of median age 77 years, with primary, biopsy-confirmed peripheral stage IA/IB NSCLC. All patients were treated with 60 Gy in 3 fractions with a median treatment time of six days. Local, regional, and distant failures were evaluated independently according to the terms of RTOG1021. Local, regional, and distant control, overall- and progression-free survival were estimated by the Kaplan-Meier method. Cox proportional hazards regression was performed to determine whether SUV(max), age, KPS, gender, tumor size/T stage, or smoking history influenced outcomes. SUV(max) was evaluated as both a continuous and as a dichotomous variable using a cutoff of <5 and ≥ 5.ResultsMedian follow-up for the cohort was 16 months. Median OS and PFS were 25.3 and 40.3 months, respectively. SUV with a cutoff value of 5 predicted for OS and PFS (p = .024 for each) but did not achieve significance for LC (p = .256). On Cox univariate regression analysis, SUV as a dichotomous variable predicted for both OS and PFS (p = .027 and p = .030, respectively). Defined as a continuous variable, SUV(max) continued to predict for OS and PFS (p = .032 and p = .003), but also predicted LC (p = .045) and trended toward significance for DC (p = .059). SUV(max) did not predict for OS as a dichotomous or continuous variable. It did, however, predict for PFS as a continuous variable (p = .008), neared significance for local control (p = .057) and trended towards, significance for distant control (p = .092).ConclusionsSUV(max) appears to be a statistically and clinically significant independent prognostic marker for progression-free survival in patients with stage I NSCLC treated with SBRT. Prospective studies to more accurately define the role of tumor FDG uptake in the prognosis of NSCLC are warranted.

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