Early reduction in tumour [18F]fluorothymidine (FLT) uptake in patients with non-small cell lung cancer (NSCLC) treated with radiotherapy alone

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• 作者：Ioannis Trigonis (1)
  Pek Keng Koh (2)
  Ben Taylor (3)
  Mahbubunnabi Tamal (1)
  David Ryder (3)
  Mark Earl (3)
  Jose Anton-Rodriguez (1)
  Kate Haslett (2) (3)
  Helen Young (4)
  Corinne Faivre-Finn (2) (3)
  Fiona Blackhall (2) (3)
  Alan Jackson (1)
  Marie-Claude Asselin (1)
  
• 关键词：[18F]Fluorothymidine PET ; Non ; small cell lung cancer ; Radiotherapy ; Early response monitoring
• 刊名：European Journal of Nuclear Medicine and Molecular Imaging
• 出版年：2014
• 出版时间：April 2014
• 年：2014
• 卷：41
• 期：4
• 页码：682-693
• 全文大小：1,159 KB
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• 作者单位：Ioannis Trigonis (1)
  Pek Keng Koh (2)
  Ben Taylor (3)
  Mahbubunnabi Tamal (1)
  David Ryder (3)
  Mark Earl (3)
  Jose Anton-Rodriguez (1)
  Kate Haslett (2) (3)
  Helen Young (4)
  Corinne Faivre-Finn (2) (3)
  Fiona Blackhall (2) (3)
  Alan Jackson (1)
  Marie-Claude Asselin (1)
  
  1. Institute of Population Health, Wolfson Molecular Imaging Centre, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, M20 3LJ, UK
  2. Manchester Cancer Research Centre, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, M20 4BX, UK
  3. The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK
  4. AstraZeneca Pharmaceuticals, Alderley Park, Macclesfield, SK10 4TG, UK
  
• ISSN：1619-7089

文摘

Purpose Changes in tumour 3-deoxy-3-[18F]fluorothymidine (FLT) uptake during concurrent chemo-radiotherapy in patients with non-small cell lung cancer (NSCLC) have been reported, at variable time points, in two pilot positron emission tomography (PET) studies. The aim of this study was to assess whether FLT changes occur early in response to radiotherapy (RT) without concurrent chemotherapy and whether such changes exceed test-retest variability. Methods Sixteen patients with NSCLC, scheduled to have radical RT, underwent FLT PET once/twice at baseline to assess reproducibility and/or after 5-1 RT fractions to evaluate response. Primary and nodal malignant lesions were manually delineated on CT and volume, mean and maximum standardized uptake values (SUVmean and SUVmax) estimated. Analysis included descriptive statistics and parameter fitting to a mixed-effects model accounting for patients having different numbers of evaluable lesions. Results In all, 35 FLT PET scans from 7 patients with a total of 18 lesions and 12 patients with a total of 30 lesions were evaluated for reproducibility and response, respectively. SUVmean reproducibility in primary tumours (SD 8.9?%) was better than SUVmax reproducibility (SD 12.6?%). In nodes, SUVmean and SUVmax reproducibilities (SD 18.0 and 17.2?%) were comparable but worse than for primary tumours. After 5-1 RT fractions, primary tumour SUVmean decreased significantly by 25?% (p--.0001) in the absence of significant volumetric change, whereas metastatic nodes decreased in volume by 31?% (p--.020) with a larger SUVmean decrease of 40?% (p-lt;-.0001). Similar changes were found for SUVmax. Conclusion Across this group of NSCLC patients, RT induced an early, significant decrease in lesion FLT uptake exceeding test-retest variability. This effect is variable between patients, appears distinct between primary and metastatic nodal lesions, and in primary tumours is lower than previously reported for concurrent chemo-RT at a similar time point. These results confirm the potential for FLT PET to report early on radiation response and to enhance the clinical development of novel drug-radiation combinations by providing an interpretable, early pharmacodynamic end point.