SAN DIEGO — Combining
The approach results in “a better definition of nodal disease and tumor extent, especially in cases of atelectasis,” Dr. Francesco Giammarile said at the annual meeting of the Society of Nuclear Medicine. “In our study, the approach to radiotherapy was modified in about 40% of patients.”
Dr. Giammarile, of the Centre Léon Bérard, Lyon, France, and associates evaluated 120 men and 28 women with NSCLC. The mean age of patients was 61 years, and 77% had stage IIIA or higher disease.
To define the gross clinical and target volumes, the researchers first used CT data only, followed by coregistered FDG-PET/CT data. They designed treatment plans with the CT data, but they left open the possibility for treatment modifications based on what the combined FDG-PET/CT data showed.
Dr. Giammarile reported that combined FDG-PET/CT provided additional diagnostic information in 61% of patients and showed unexpected tumor localization in 42%. Of these, 8% were at extrathoracic metastatic sites.
In 26% of cases, there was no pathologic uptake at known disease sites. “Four patients were thus shifted from radical to palliative radiotherapy for metastatic disease or very large tumor size,” the researchers wrote in their abstract. The switch resulted in an estimated per-patient savings of 490 euros in additional treatment costs, or about 616 U.S. dollars.
The study was supported by a grant from the French Ministry of Health.