Is FDG-PET Suitable for Evaluating Neoadjuvant Therapy in Non-Small Cell Lung Cancer? Evidence With Systematic Review of the Literature

TY - JOUR

T1 - Is FDG-PET Suitable for Evaluating Neoadjuvant Therapy in Non-Small Cell Lung Cancer? Evidence With Systematic Review of the Literature

AU - Rebollo-Aguirre, A. C.

AU - Ramos-Font, C.

AU - Portero, R. V.

AU - Cook, G. J. R.

AU - Elvira, J. M. L.

AU - Tabares, A. R.

N1 - M1 - 6 Rebollo-Aguirre, Angel C. Ramos-Font, Carlos Villegas Portero, Roman Cook, Gary J. R. Llamas Elvira, Jose Manuel Romero Tabares, Antonio

PY - 2010/5/1

Y1 - 2010/5/1

N2 - Background: Neoadjuvant therapy response assessment is crucial in patients with non-small cell lung cancer (NSCLC). FDG-PET has emerged as a valuable tool for defining therapy response assessment in other tumours. Aim: To systematically review publications appearing in the literature describing induction therapy response assessment with FDG-PET in NSCLC. Methods: We performed a bibliographic search and selected only prospective studies in order to include the highest levels of evidence. Results: Nine of 497 potentially relevant publications were selected. The ranges of sensitivity, specificity, positive predictive value and negative predictive value for primary tumour response assessment were 80-100%, 0-100%, 42.9-100%, and 66.7-100%, respectively. Pooling data for N2 restaging after neoadjuvant response the overall sensitivity was 63.8% (95% CI, 53.3-73.7%) and overall specificity was 85.3% (95% CI, 80.4-89.4%). Conclusion: The results of the analysis do not support the use of FDG-PET as the only re-assessment tool for mediastinal lymph node evaluation for routine clinical use. FDG-PET seems to predict primary tumour response to induction therapy but it could not be shown by pooling analysis. J. Surg. Oncol. 2010;101:486-494. (C) 2010 Wiley-Liss, Inc.

AB - Background: Neoadjuvant therapy response assessment is crucial in patients with non-small cell lung cancer (NSCLC). FDG-PET has emerged as a valuable tool for defining therapy response assessment in other tumours. Aim: To systematically review publications appearing in the literature describing induction therapy response assessment with FDG-PET in NSCLC. Methods: We performed a bibliographic search and selected only prospective studies in order to include the highest levels of evidence. Results: Nine of 497 potentially relevant publications were selected. The ranges of sensitivity, specificity, positive predictive value and negative predictive value for primary tumour response assessment were 80-100%, 0-100%, 42.9-100%, and 66.7-100%, respectively. Pooling data for N2 restaging after neoadjuvant response the overall sensitivity was 63.8% (95% CI, 53.3-73.7%) and overall specificity was 85.3% (95% CI, 80.4-89.4%). Conclusion: The results of the analysis do not support the use of FDG-PET as the only re-assessment tool for mediastinal lymph node evaluation for routine clinical use. FDG-PET seems to predict primary tumour response to induction therapy but it could not be shown by pooling analysis. J. Surg. Oncol. 2010;101:486-494. (C) 2010 Wiley-Liss, Inc.

U2 - 10.1002/jso.21525

DO - 10.1002/jso.21525

M3 - Article

SN - 0022-4790

VL - 101

SP - 486

EP - 494

JO - Journal of Surgical Oncology

JF - Journal of Surgical Oncology

IS - 6

ER -