The Lancet Regional Health. Americas (Jul 2022)

Applying PET-CT for predicting the efficacy of SBRT to inoperable early-stage lung adenocarcinoma: A Brazilian case-series

  • Fabio Y. Moraes,
  • Carlos E.C.V. Abreu,
  • Gabriela S.M. Siqueira,
  • Cecilia K. Haddad,
  • Fabiana A.M. Degrande,
  • Wilma M. Hopman,
  • Wellington F.P. Neves-Junior,
  • Rafael Gadia,
  • Heloisa A. Carvalho

Journal volume & issue
Vol. 11
p. 100241

Abstract

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Summary: Background: Stereotactic body radiotherapy (SBRT) is a treatment option for early-stage inoperable primary lung cancer. Here we report a thorough description of the prognostic value of pre-SBRT SUVmax for predicting the efficacy of SBRT in early-stage lung adenocarcinoma. Methods: This is a retrospective study of consecutive cases of early-stage inoperable lung adenocarcinoma, staged with PET-CT, treated with SBRT between 2007 and 17. Kaplan-Meier (KM) curves were used to assess overall survival and compare time to event between those with PET-CT SUVmax values ≤ 5.0 and those > 5. Fisher's Exact tests and the Mann-Whitney U were used to compare the patient and clinical data of those with SUVmax≤5.0 and >5.0, and those with and without any failure. Findings: Amongst 50 lung carcinoma lesions, from 47 patients (34 (68%)-T1a or 5 (p = 0.112). In addition, 5 experienced a regional failure and 4 a distant failure. Higher PET-CT SUVmax values before SBRT were associated with an increased risk of any failure (36% versus 0%, p = 0.0040 on Fisher's Exact test) and faster time to event (p = 0.010, log rank test). Both acute and late toxicities profile were acceptable. Interpretation: Patients with early-stage inoperable lung adenocarcinoma present good clinical outcomes when treated with SBRT. We raised the hypothesis that the value of PET-CT SUVmax before SBRT may be an important predictive factor in disease control. Funding: None.

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