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European Journal of Nuclear Medicine and Molecular Imaging

Erschienen in:

13.03.2019 | Original Article

Radiotherapy boost in patients with hypoxic lesions identified by ¹⁸F-FMISO PET/CT in non-small-cell lung carcinoma: can we expect a better survival outcome without toxicity? [RTEP5 long-term follow-up]

verfasst von: Pierre Vera, Sorina-Dana Mihailescu, Justine Lequesne, Romain Modzelewski, Pierre Bohn, Sébastien Hapdey, Louis-Ferdinand Pépin, Bernard Dubray, Philippe Chaumet-Riffaud, Pierre Decazes, Sébastien Thureau, all investigators of RTEP5 study (list in annexe)

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 7/2019

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Abstract

Purpose

Chemoradiotherapy is the reference curative-intent treatment for nonresectable locally advanced non-small-cell lung carcinoma (NSCLC), with unsatisfactory survival, partially due to radiation resistance in hypoxic tissues. The objective was to update survival and toxicity at 3 years following radiotherapy boost to hypoxic tumours in NSCLC patients treated with curative-intent chemoradiotherapy.

Methods

This was an open-label, nonrandomized, multicentre, phase II clinical trial. ¹⁸F-Fluoromisonidazole (¹⁸F-FMISO) PET/CT was used to determine the hypoxic profile of the patients. ¹⁸F-FMISO-positive patients and those without organ-at-risk constraints received a radiotherapy boost (70–84 Gy); the others received standard radiotherapy (66 Gy). Overall survival (OS), progression-free survival (PFS) and safety were assessed.

Results

A total of 54 patients were evaluated. OS and PFS rates at 3 years were 48.5% and 28.8%, respectively. The median OS in the ¹⁸F-FMISO-positive patients was 25.8 months and was not reached in the ¹⁸F-FMISO-negative patients (p = 0.01). A difference between the groups was also observed for PFS (12 months vs. 26.2 months, p = 0.048). In ¹⁸F-FMISO-positive patients, no difference was observed in OS in relation to dose, probably because of the small sample size (p = 0.30). However, the median OS seemed to be in favour of patients who received the radiotherapy boost (26.5 vs. 15.3 months, p = 0.71). In patients who received the radiotherapy boost, no significant late toxicities were observed.

Conclusion

¹⁸F-FMISO uptake in NSCLC patients is strongly associated with features indicating a poor prognosis. In ¹⁸F-FMISO-positive patients, the radiotherapy boost seemed to improve the OS by 11.2 months. A further clinical trial is needed to investigate the efficacy of a radiotherapy boost in patients with hypoxic tumours.

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Titel: Radiotherapy boost in patients with hypoxic lesions identified by 18F-FMISO PET/CT in non-small-cell lung carcinoma: can we expect a better survival outcome without toxicity? [RTEP5 long-term follow-up]
verfasst von: Pierre Vera
Sorina-Dana Mihailescu
Justine Lequesne
Romain Modzelewski
Pierre Bohn
Sébastien Hapdey
Louis-Ferdinand Pépin
Bernard Dubray
Philippe Chaumet-Riffaud
Pierre Decazes
Sébastien Thureau
all investigators of RTEP5 study (list in annexe)
Publikationsdatum: 13.03.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 7/2019
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-019-04285-9

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Radiotherapy boost in patients with hypoxic lesions identified by ¹⁸F-FMISO PET/CT in non-small-cell lung carcinoma: can we expect a better survival outcome without toxicity? [RTEP5 long-term follow-up]

Abstract

Purpose

Methods

Results

Conclusion

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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