Randomized Controlled Trial of the Role of Positron Emission Tomography in the Management of Stage I and II Non-Small-Cell Lung Cancer

Viney, Rosalie; Boyer, Michael; King, Madeleine; Kenny, Patricia; Pollicino, Christine; McLean, Jocelyn; McCaughan, Brian C.; Fulham, Michael

doi:10.1200/jco.2004.04.126

Cited by 180 publications

(89 citation statements)

References 16 publications

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“…The significant reduction in planned surgery with FDG-PET supports the cost-effectiveness and benefit to the patient of the approach. However, in a separate randomized, controlled trial in which advanced-stage cancer was rarely identified (2 cases among the 184 enrolled stage I-II patients), FDG-PET did not reduce unnecessary thoracotomies but did influence patient management (63). The prognostic significance of FDG-PET in NSCLC has also been established (64,65).…”

Section: Fdg-pet Validated For Staging and Diagnosis: A Biomarker Of mentioning

confidence: 99%

Progress and Promise of FDG-PET Imaging for Cancer Patient Management and Oncologic Drug Development

Kelloff

Hoffman

Johnson

et al. 2005

Clinical Cancer Research

605

382

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2-[ 18 F]Fluoro-2-deoxyglucose positron emission tomography (FDG-PET) assesses a fundamentalpropertyof neoplasia, theWarburgeffect.This molecularimaging technique offers acomplementary approach to anatomic imaging that is more sensitive and specific in certain cancers. FDG-PET has been widely applied in oncology primarily as a staging and restaging tool that can guide patient care. However, because it accurately detects recurrent or residual disease, FDG-PETalso has significant potential for assessing therapy response. In this regard, it canimprove patient management by identifying responders early, before tumor size is reduced; nonresponders could discontinue futile therapy. Moreover, a reductioninthe FDG-PETsignal withindays or weeks of initiating therapy (e.g., in lymphoma, non^small cell lung, and esophageal cancer) significantly correlates with prolonged survival and other clinical end points now usedin drug approvals.These findings suggest that FDGPETcould facilitate drug development as an early surrogate of clinicalbenefit.This article reviews the scientificbasis ofFDG-PETandits development andapplicationasavaluableoncologyimagingtool. Its potential to facilitate drug development in seven oncologic settings (lung, lymphoma, breast, prostate, sarcoma, colorectal, and ovary) is addressed. Recommendations include initial validation against approved therapies, retrospective analyses to define the magnitude of change indicative of response, further prospective validation as a surrogate of clinical benefit, and application as a phase II/III trial end point to accelerate evaluation and approval of novel regimens and therapies. FDG-PET (2-[18 F]Fluoro-2-deoxyglucose positron emission tomography) is an accepted and widely used clinical imaging tool in oncology. U.S. Medicare reimbursement of FDG-PET recently expanded to encompass all cancer patients participating in certain prospective studies or registries in addition to more general coverage in 10 defined oncologic settings. Primarily covered are disease diagnosis, staging, and restaging, but FDG-PET is also approved for monitoring response to therapy in locally advanced and metastatic breast cancers when a change in therapy is anticipated. Clinical trials in breast cancer and other settings [e.g., non -small cell lung cancer (NSCLC) and esophageal cancer] have shown that FDG-PET imaging can provide an early indication of therapeutic response that is well correlated with clinical outcome. FDG-PET thus has the potential to improve patient management, particularly by signaling the need for early therapeutic changes in nonresponders, thereby obviating the side effects and costs of ineffective treatment. As an early surrogate for clinical benefit, the modality also has the potential to facilitate oncologic drug development by shortening phase II trials and detecting clinical benefit earlier in phase III investigations. Studies to further explore and validate these approaches are needed and can be conducted in parallel with those employing end points now use...

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Section: Fdg-pet Validated For Staging and Diagnosis: A Biomarker Of mentioning

confidence: 99%

Progress and Promise of FDG-PET Imaging for Cancer Patient Management and Oncologic Drug Development

Kelloff

Hoffman

Johnson

et al. 2005

Clinical Cancer Research

605

382

View full text Add to dashboard Cite

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“…Their results were different. Viney et al (20) have faced as primary result the performance of thoracotomy, which was performed in 98% of their patients of the CS group and in 96% of the group MS with FDG-PET besides CS (p = 0.44), and demonstrated that the addition of PET did not significantly reduce the number of thoracotomies. The main result of the study developed by van Tinteren et al…”

Section: Discussionmentioning

confidence: 99%

A tomografia por emissão de pósitrons com 2-[18F]-fluoro-2-desoxi-D-glicose é custo-efetiva em pacientes com câncer de pulmão não pequenas células no Brasil

Cerci

Takagaki

Trindade³

et al. 2012

Radiol Bras

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“…FDG PET/ BT görüntüleme uzak metastazların gösterilmesinde konvansiyonel tanısal incelemelerden daha başarılıdır (Şekil 2) (29,30,31,32,33,34,35 BT görüntülemenin ortalama duyarlılık ve özgüllük değerleri ise %93 ve %95 düzeyinde bulunmuştur (35). Uzak metastazların FDG PET/BT görüntüleme ile saptanması hastaların klinik evrelemesinde yaklaşık %20 oranında değişikliğe neden olur (32). Özet olarak, beyin metastazları dışında FDG PET/BT görüntüleme akciğer kanserinin uzak metastazlarını belirlemede yüksek duyarlılık ve özgüllük değerlerine sahiptir.…”

Section: Uzak Metastazların Gösterilmesiunclassified

Role of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Imaging in Diagnosis and Staging of Lung Cancer

Akdemir¹,

Aydos²

2018

Nts

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GirişAkciğer kanseri, en sık görülen kanser türlerinden biri olup, tedavi olanaklarındaki iyileşmelere rağmen kansere bağlı ölüm nedenleri arasında birinci sırada yer alır (1). Tüm akciğer kanserlerinin yaklaşık %85'ini küçük hücreli dışı akciğer kanseri (KHDAK), kalan kısmını da küçük hücreli akciğer kanseri (KHAK) oluşturur (2).KHAK hastalarının çoğunda tanı anında uzak metastaz bulunması ve bu hastaların cerrahi tedavi olasılıklarının düşük olması; buna karşılık KHDAK hastalarında cerrahi tedavi olasılığının daha yüksek olması nedeniyle bu sınıflama özellikle tedavi yaklaşımı bakımından önem taşır. Akciğer kanseri tanısı alan hastalarda uygun tedavi seçeneğini belirlemek ve hasta prognozunu Flor-18 ile işaretli florodeoksiglikoz (FDG) ile yapılan pozitron emisyon tomografisi/bilgisayarlı tomografi (PET/ BT) akciğerde kuşkulu parankimal nodülü olan veya akciğer kanseri tanısı alan hastaların klinik yönetiminde kullanılan güçlü bir tanı aracıdır. Bu yazıda FDG PET/BT görüntülemenin kuşkulu akciğer nodüllerinin değerlendirilmesinde ve yeni tanı akciğer kanserinde evrelemesindeki yerinden, sayısal PET değişkenlerinin hasta prognozu ile ilişkisinden, hibrid PET/manyetik rezonans sistemi gibi teknik gelişmelerden ve akciğer kanserinin patofizyolojisi ile ilişkili FDG dışındaki diğer PET radyofarmasötiklerinin kullanımından bahsedilmektedir. Anahtar Kelimeler: Akciğer kanseri, küçük hücreli-dışı akciğer kanseri, küçük hücreli akciğer kanseri, FDG, PET/BT görüntüleme Positron emission tomography/computed tomography (PET/ CT) using fluorine-18 labelled fluorodeoxyglucose (FDG) is a powerful tool for managing patients with suspected lung nodules and lung cancer. In this review, we discuss the utility of FDG PET/CT imaging in evaluation of suspected pulmonary nodules and initial staging of patients with newly diagnosed lung cancer, prognostic value of quantitative PET parameters, technical developments in PET imaging such as hybrid PET/ magnetic resonance systems, and the use of other PET radiopharmaceuticals related to lung cancer pathophysiology.

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Randomized Controlled Trial of the Role of Positron Emission Tomography in the Management of Stage I and II Non-Small-Cell Lung Cancer

Abstract: For patients who are carefully and appropriately staged as having stage I-II disease, PET provides potential for more appropriate stage-specific therapy but may not lead to a significant reduction in the number of thoracotomies avoided.

Cited by 180 publications

References 16 publications

Progress and Promise of FDG-PET Imaging for Cancer Patient Management and Oncologic Drug Development

Progress and Promise of FDG-PET Imaging for Cancer Patient Management and Oncologic Drug Development

A tomografia por emissão de pósitrons com 2-[18F]-fluoro-2-desoxi-D-glicose é custo-efetiva em pacientes com câncer de pulmão não pequenas células no Brasil

Role of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Imaging in Diagnosis and Staging of Lung Cancer

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