Is %ΔSUVmax a Useful Indicator of Survival in Patients with Advanced Nonsmall-Cell Lung Cancer?

Purpose. To investigate the impact of the maximum standardized uptake value (SUVmax), size of primary lung lesion, and %Delta SUVmax on outcome (overall survival (OS) and 2-year disease-free survival (2-yearDFS)) of patients with advanced nonsmall-cell lung cancer (NSCLC). Materials and Methods. 86 stage III-IV NSCLC patients underwent 18 F-FDGPET/CT, before and after chemotherapy, and were classified into subgroups according to the response criteria of the European Organization for Research and Treatment of Cancer. SUVmax values and tumor size with the best prognostic significance were searched. Correlation between the SUVmax value and the initial response to therapy (best response) and the relationship between %Delta SUVmax and OS were assessed. Results. In patients in PD (20/86), the average pretreatment SUVmax was 11.8 +/- 5.23, and the mean size of the primary lesion was 43.35 mm +/- 16.63. In SD, PR, and CR patients (66/86), the average pretreatment SUVmax was 12.7 +/- 8.05, and the mean size of the primary lesion was 41.6 mm +/- 21.15. Correlation was identified only for %Delta SUVmax; patients with PD (Delta SUVmax > + 25%) showed a worse OS than patients with Delta SUVmax < + 25% (CR, PR, and SD) (P = 0.0235). Conclusions. In stage III-IV NSCLC, among the assessed factors, only %Delta SUVmax may be considered as a useful prognostic factor.