Table 1.
Population characteristics.
Fig 1.
66-year-old patient with T2N2 (Stage IIIA) left upper lobe squamous cell carcinoma. At baseline (a), tumor SUVmax was 12 g/ml, MTV 13 cc and TLG 89 g. After 2 cycles of carboplatin-paclitaxel (b), SUVmax was 8.2 g/ml (ΔSUVmax = -33%), MTV 2.4 cc (ΔMTV = -82%) and TLG 11.3 g (ΔTLG = -87%). After 45 months, the patient was still alive and showed no sign of recurrence.
Table 2.
PET data and univariate analysis.
Table 3.
Multivariate analysis.
Fig 2.
FDG PET parameters and survival curves.
Survival curves using the Kaplan-Meier method. (a) PFS was longer for patients with low TLG2 (HR = 2.8, 95%CI 1.3–5.9, p< 0.01). After 2 years, the survival rate was 67% for the 30 patients with low TLG2 vs 34% for the 20 others. Median survival was respectively reached at 31 and 16 months. (b) 21 patients with high decrease of TLG after therapy (ΔTLG < -81%) showed longer OS (HR = 3.8, 95%CI 1.5–9.6, p = 0.02). After 1 year and after 2 years, survival rates for the 21 good responders were 91% versus 76% and 59% for the 29 bad responders. Median survival was not reached for good responders and was 29 months for the others. (c) Survival curves showed longer OS for patients with low TLG2 (HR = 7.1, 95%CI 2.8–18, p< 0.01). After 2 years, the survival rate was 89% for the 21 patients with low TLG2 (median survival not reached) vs 52% for the other 29 patients (median survival at 28 months).
Fig 3.
Overall survival using the composite parameter.
Group A: 31 patients with low MTV2 or high decrease of SUVmax after induction therapy. Group B: 19 patients with high MTV2 (> 23 cc) and low decrease of SUVmax (ΔSUVmax> -55%). Median survival was not reached in Group A and was 17.5 months in Group B. HR = 5.7, 95%CI 2.1–15.4, p< 0.001.