[18F]fludeoxyglucose PET/CT in small-cell lung cancerCitation formats
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[18F]fludeoxyglucose PET/CT in small-cell lung cancer : Analysis of the CONVERT randomized controlled trial. / Manoharan, Prakash; Salem, Ahmed; Mistry, Hitesh; Gornall, Michael; Harden, Susan; Julyan, Peter; Locke, Imogen; McAleese, Jonathan; McMenemin, Rhona; Mohammed, Nazia; Snee, Michael; Woods, Sarah; Westwood, Thomas; Faivre-Finn, Corinne.
In: Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2019.Research output: Contribution to journal › Article › peer-review
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TY - JOUR
T1 - [18F]fludeoxyglucose PET/CT in small-cell lung cancer
T2 - Analysis of the CONVERT randomized controlled trial
AU - Manoharan, Prakash
AU - Salem, Ahmed
AU - Mistry, Hitesh
AU - Gornall, Michael
AU - Harden, Susan
AU - Julyan, Peter
AU - Locke, Imogen
AU - McAleese, Jonathan
AU - McMenemin, Rhona
AU - Mohammed, Nazia
AU - Snee, Michael
AU - Woods, Sarah
AU - Westwood, Thomas
AU - Faivre-Finn, Corinne
N1 - Copyright © 2019. Published by Elsevier Inc.
PY - 2019
Y1 - 2019
N2 - INTRODUCTION: We used phase-3 CONVERT trial data to investigate the impact of 18fludeoxyglucose (18F-FDG) PET/CT in small-cell lung cancer (SCLC).METHODS: CONVERT randomized limited-stage SCLC patients to twice-daily (45Gy in 30-fractions) or once-daily (66Gy in 33-fractions) chemoradiotherapy. Patients were divided into 2 groups in this unplanned analysis: those staged with conventional imaging (contrast-enhanced thorax and abdomen CT and brain imaging with/without bone scintigraphy) and those staged with 18F-FDG PET/CT in addition.RESULTS: 540 patients were analyzed. Compared to patients who underwent conventional imaging (n=231), patients also staged with 18F-FDG PET/CT (n=309) had smaller gross tumor volume (P=0·003), were less likely to have elevated pre-treatment serum lactate dehydrogenase (P=0·035), and received more chemotherapy (P=0·026). There were no significant differences in overall (HR 0·87 [95% CI 0·70-1·08]; P=0·192) and progression-free survival (HR 0·87 [95% CI 0·71-1·07]; P=0·198) between patients staged with or without 18F-FDG PET/CT. In the conventional imaging group, we found no survival difference between patients staged with or without bone scintigraphy. While there were no differences in delivered radiotherapy dose, 18F-FDG PET/CT-staged patients received lower normal tissue (lung, heart, and esophagus) radiation doses. Apart from higher incidence of late esophagitis in patients staged with conventional imaging (grade ≥1: 19% vs 11%; P=0·012), the incidence of acute and late radiotherapy-related toxicities was not different between the two groups.CONCLUSION: In CONVERT, survival outcomes were not significantly different in patients staged with or without 18F-FDG PET/CT. However, this analysis cannot support the use or omission of 18F-FDG PET/CT due to study limitations.
AB - INTRODUCTION: We used phase-3 CONVERT trial data to investigate the impact of 18fludeoxyglucose (18F-FDG) PET/CT in small-cell lung cancer (SCLC).METHODS: CONVERT randomized limited-stage SCLC patients to twice-daily (45Gy in 30-fractions) or once-daily (66Gy in 33-fractions) chemoradiotherapy. Patients were divided into 2 groups in this unplanned analysis: those staged with conventional imaging (contrast-enhanced thorax and abdomen CT and brain imaging with/without bone scintigraphy) and those staged with 18F-FDG PET/CT in addition.RESULTS: 540 patients were analyzed. Compared to patients who underwent conventional imaging (n=231), patients also staged with 18F-FDG PET/CT (n=309) had smaller gross tumor volume (P=0·003), were less likely to have elevated pre-treatment serum lactate dehydrogenase (P=0·035), and received more chemotherapy (P=0·026). There were no significant differences in overall (HR 0·87 [95% CI 0·70-1·08]; P=0·192) and progression-free survival (HR 0·87 [95% CI 0·71-1·07]; P=0·198) between patients staged with or without 18F-FDG PET/CT. In the conventional imaging group, we found no survival difference between patients staged with or without bone scintigraphy. While there were no differences in delivered radiotherapy dose, 18F-FDG PET/CT-staged patients received lower normal tissue (lung, heart, and esophagus) radiation doses. Apart from higher incidence of late esophagitis in patients staged with conventional imaging (grade ≥1: 19% vs 11%; P=0·012), the incidence of acute and late radiotherapy-related toxicities was not different between the two groups.CONCLUSION: In CONVERT, survival outcomes were not significantly different in patients staged with or without 18F-FDG PET/CT. However, this analysis cannot support the use or omission of 18F-FDG PET/CT due to study limitations.
KW - small-cell
KW - lung cancer
KW - 18F-FDG PET/CT
KW - staging
KW - survival
U2 - 10.1016/j.jtho.2019.03.023
DO - 10.1016/j.jtho.2019.03.023
M3 - Article
C2 - 31002954
JO - Journal of Thoracic Oncology
JF - Journal of Thoracic Oncology
SN - 1556-0864
ER -