F-18 fluorodeoxyglucose positron emission tomography staging in radical radiotherapy candidates with nonsmall cell lung carcinoma

Manus, Michael P. Mac; Hicks, Rodney J.; Ball, David; Kalff, Victor; Matthews, Jane P.; Salminen, Eeva; Khaw, Pearly; Wirth, Andrew; Rischin, Danny; McKenzie, A L

doi:10.1002/1097-0142(20010815)92:4<886::aid-cncr1397>3.0.co;2-v

Cited by 211 publications

(100 citation statements)

References 29 publications

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“…The integration of advanced technology will be used to minimize expansions of target volumes and help ensure accuracy of treatment in an effort to limit doses to critical normal structures. For example, functional imaging with FDG-PET will be employed for target delineation [80], four-dimensional planning and measures to account for tumor motion will be incorporated, and imageguided radiotherapy will be performed directly prior to each fraction to limit target volume expansion [81]. Intensity-modulated TRT will also be favored to further avoid exposing critical structures to high-dose TRT.…”

Section: Trt Considerationsmentioning

confidence: 99%

Novel Approaches of Chemoradiotherapy in Unresectable Stage IIIA and Stage IIIB Non-Small Cell Lung Cancer

Stinchcombe

2012

The Oncologist

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After completing this course, the reader will be able to:1. Describe the current status of phase II trials with novel agents in order to distinguish the role of phase III trials in determining the role of novel agents.2. Describe target therapy in stage III non-small cell lung cancer and discuss the status of personalized medicine in stage III disease.3. State the current standard for thoracic radiation therapy and the current status of hypofractionated, adaptive radiotherapy and proton therapy and evaluate the recent radiation therapy oncology group (RTOG) 0617 trial.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACT

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Section: Trt Considerationsmentioning

confidence: 99%

Novel Approaches of Chemoradiotherapy in Unresectable Stage IIIA and Stage IIIB Non-Small Cell Lung Cancer

Stinchcombe

2012

The Oncologist

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“…The fact that PET imaging is functional rather than structural limits its value in local tumour staging, but numerous studies have shown an effect in the identification of regional and distant disease (Rinne et al, 1998;Dwamena et al, 1999;Gould et al, 2001;Hellwig et al, 2001;Kalff et al, 2002), treatment decisions (MacManus et al, 2001;Spaepen et al, 2001;Blum et al, 2003;Heriot et al, 2004), radiotherapy planning (Haustermans et al, 2002;MacManus and Hicks, 2003;Leong et al, 2006) and in the prediction of response (Di Fabio et al, 2005;Duong et al, 2006).…”

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confidence: 99%

The impact of 18-fluorodeoxyglucose positron emission tomography on the staging, management and outcome of anal cancer

et al. 2009

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Accurate inguinal and pelvic nodal staging in anal cancer is important for the prognosis and planning of radiation fields. There is evidence for the role of 18-fluorodeoxyglucose positron emission tomography (FDG-PET) in the staging and management of cancer, with early reports of an increasing role in outcome prognostication in a number of tumours. We aimed to determine the effect of FDG-PET on the nodal staging, radiotherapy planning and prognostication of patients with primary anal cancer. Sixty-one consecutive patients with anal cancer who were referred to a tertiary centre between August 1997 and November 2005 were staged with conventional imaging (CIm) (including computed tomography (CT), magnetic resonance imaging, endoscopic ultrasound and chest X-ray) and by FDG-PET. The stage determined by CIm and the proposed management plan were prospectively recorded and changes in stage and management as a result of FDG-PET assessed. Patients were treated with a uniform radiotherapy technique and dose. The accuracy of changes and prognostication of FDG-PET were validated by subsequent clinical follow-up. Kaplan -Meier survival analysis was used to estimate survival for the whole cohort and by FDG-PET and CIm stage. The tumour-stage group was changed in 23% (14 out of 61) as a result of FDG-PET (15% up-staged, 8% down-staged). Fourteen percent of T1 patients (3 out of 22), 42% of T2 patients (10 out of 24) and 40% of T3 -4 patients (6 out of 15) assessed using CIm, had a change in their nodal or metastatic stage following FDG-PET. Sensitivity for nodal regional disease by FDG-PET and CIm was 89% and 62%, respectively. The staging FDG-PET scan altered management intent in 3% (2 out of 61) and radiotherapy fields in 13% (8 out of 61). The estimated 5-year overall survival (OS) and progression-free survival (PFS) for the cohort were 77.3% (95% confidence interval (CI): 55.3 -90.4%) and 72.2% (95% CI: 51.5 -86.4%), respectively. The estimated 5-year PFS for FDG-PET and CIm staged N2-3 disease was 70% (95% CI: 42.8 -87.9%) and 55.3% (95% CI: 23.3 -83.4%), respectively. FDG-PET shows increased sensitivity over CIm for staging nodal disease in anal cancer and changes treatment intent or radiotherapy prescription in a significant proportion of patients.

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“…[22][23][24] It has been demonstrated consistently that PET finds more sites of active disease than CT or other imaging methods. When faced with apparently progressing disease during treatment, referring physicians' intended management overwhelmingly was to change to a different chemotherapy agent(s) versus switching to supportive care.…”

Section: Discussionmentioning

confidence: 99%

The impact of positron emission tomography (PET) on expected management during cancer treatment

Hillner

Siegel

Shields

et al. 2009

Cancer

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BACKGROUND:Positron emission tomography (PET) performed during cancer therapy (treatment monitoring) has shown promise for predicting treatment outcome. However, when used for this purpose, PET generally is not considered standard care. Under the Medicare ‘coverage with evidence development’ policy, PET (and integrated PET/computed tomography) became a covered service for treatment monitoring if prospective registry data were collected.METHODS:The National Oncologic PET Registry collected questionnaire data on intended patient management before and after PET. Data were available from 8240 patients who had 10,497 treatment‐monitoring PET scans at 946 centers; these studies were used to monitor chemotherapy alone (82%), radiation therapy alone (6%), or combined‐modality treatment (12%). Ovarian, pancreatic, and lung cancers accounted for 37% of the cohort. In 54% of scans, the pre‐PET summary stage was metastatic disease.RESULTS:If PET had not been available, then the pre‐PET plan would have been other imaging (53%), ongoing treatment (41%), or biopsy or watching (6%). Change in the post‐PET intended management was similar in the imaging and treatment groups: 26% to 28% of scans to switching to another therapy, and 16% to 19% scans led to adjustment of the dose or duration of therapy. Changes in management were more frequent if the referring physician judged that the post‐PET prognosis was worse rather than improved or unchanged (78% vs 40%). The physicians indicated that PET enabled 91% of their patients to avoid future tests.CONCLUSIONS:Physicians often report plans to modify their therapeutic plans in elderly cancer patients when PET is used for treatment monitoring. Cancer 2009. © 2009 American Cancer Society.

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F-18 fluorodeoxyglucose positron emission tomography staging in radical radiotherapy candidates with nonsmall cell lung carcinoma

Cited by 211 publications

References 29 publications

Novel Approaches of Chemoradiotherapy in Unresectable Stage IIIA and Stage IIIB Non-Small Cell Lung Cancer

Novel Approaches of Chemoradiotherapy in Unresectable Stage IIIA and Stage IIIB Non-Small Cell Lung Cancer

The impact of 18-fluorodeoxyglucose positron emission tomography on the staging, management and outcome of anal cancer

The impact of positron emission tomography (PET) on expected management during cancer treatment

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