Details

Autor(en) / Beteiligte

• Vera, Pierre
• Mihailescu, Sorina-Dana
• Lequesne, Justine
• Modzelewski, Romain
• Bohn, Pierre
• Hapdey, Sébastien
• Pépin, Louis-Ferdinand
• Dubray, Bernard
• Chaumet-Riffaud, Philippe
• Decazes, Pierre
• Thureau, Sébastien

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]

Ist Teil von

• European journal of nuclear medicine and molecular imaging, 2019-07, Vol.46 (7), p.1448-1456

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2019

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• 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. 18 F-Fluoromisonidazole ( 18 F-FMISO) PET/CT was used to determine the hypoxic profile of the patients. 18 F-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 18 F-FMISO-positive patients was 25.8 months and was not reached in the 18 F-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 18 F-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 18 F-FMISO uptake in NSCLC patients is strongly associated with features indicating a poor prognosis. In 18 F-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.