The association of metabolic positron emission tomography/computed tomography parameters with survival in small cell lung cancer

BACKGROUND:
Small cell lung cancer (SCLC) is a lung malignancy with a poor prognosis and metastases at the time of diagnosis. There is limited experience using positron emission tomography/computed tomography (PET/CT) for SCLC diagnosis, staging, and follow-up.


OBJECTIVE:
Investigate the survival effect of primary tumor standardized uptake value max (SUVmax), SUV mean, metabolic tumor volume (MTV), total lesion glucose (TLG), bone marrow SUV (BM), and bone marrow to liver ratio (BLR) in SCLC.


DESIGN:
Retrospective


SETTING:
Single center in Turkey


PATIENTS AND METHODS:
Patients who were cyto/histologically diagnosed with SCLC and had PET/CT simultaneous with the diagnosis were included in the study.


MAIN OUTCOME MEASURES:
The effect of PET/CT parameters on overall survival (OS) and progression-free survival (PFS).


SAMPLE SIZE:
304


RESULTS:

The 5-year OS median value was 14.62 months, and the 5-year PFS was 13.01 months. In Kaplan-Meier analysis, SUVmax, MTV, and TLG were statistically significant variables in OS (
P
=.03;
P
<.001;
P
<.001, respectively). MTV and TLG were significant in PFS (
P
<.001;
P
=.0003, respectively). In the multivariate analysis, MTV was an independent PET/CT parameter associated with OS (
P
=.003), stage of disease (
P
=.012), SUVmax (
P
=.003), MTV (
P
=.016), and TLG (
P
=.005) were significant variables in PFS.



CONCLUSION:
In our study, MTV was an independent parameter that can be used to predict survival in SCLC. Considering the effect of MTV, a metabolic PET/CT parameter on survival, it can be recommended for clinical use as a standard measure of evaluation in PET/CT reports, just like SUVmax.


LIMITATIONS:
The first limitation was the single-center and retrospective design of the study. Due to the retrospective design of the study, weight loss, performance status, and smoking history could not be obtained from every patient. Second, inaccurate registration of PET and CT images due to patient respiratory movements may affect measurements.