Dataset related to article "Predictive and Prognostic Role of Metabolic Response in Patients With Stage III NSCLC Treated With Neoadjuvant Chemotherapy."

INTRODUCTION:

The purpose of this study was to assess the predictive and prognostic role of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in candidates with stage III non-small-cell lung cancer (NSCLC) to neoadjuvant chemotherapy.

PATIENTS AND METHODS:

Sixty-six patients with stage III NSCLC treated with induction chemotherapy from March 2013 to December 2017 were retrospectively identified. Response assessment were evaluated according to the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and European Organisation for Research and Treatment of Cancer (EORTC) criteria. 18F-FDG PET/CT metabolic parameters were analyzed as absolute values as well as percentage changes (Δ) between 2 consecutive scans, for primary tumor (T) and for regional lymph nodes (N). All clinical variables and metabolic parameters were compared with treatment response and correlated with progression-free survival (PFS) and overall survival (OS), based on a median follow-up of 9.4 months.

RESULTS:

Post-induction therapy standardized uptake value (SUV)max_T, SUVmean_T, metabolic tumor volume (MTV_T), and total lesion glycolysis of the tumor (TLG_T) varied significantly between responders and non-responders (6.6 vs. 13.8; P = .001; 4.2 vs. 8.1; P < .001; 6 vs. 17.9; P = .002; and 24.1 vs. 136.3; P < .001, respectively). Likewise, percentage changes (Δ_T) were significantly different between the 2 groups (P < .001). Along with primary tumor, also post-SUVmax_N, post-SUVmean_N, and post-TLG_N (P = .024, P = .015, and P = .024, respectively), as well as all percentage changes (Δ_N) were different between responders and non-responders. RECIST 1.1 and EORTC response classifications were discordant in 27 patients (40.9%; κ = 0.265; P = .003). On multivariate analysis, post-TLG_N was an independent predictor for both PFS and OS, whereas RECIST 1.1 was a predictor only for OS.

CONCLUSIONS:

Several metabolic parameters may differentiate responders from non-responders following neoadjuvant chemotherapy in stage III NSCLC. As compared with RECIST 1.1, EORTC seems to be more appropriate for evaluation therapeutic response. Finally, post-TLG_N has significant prognostic information.

引言：
本研究旨在评估18F-氟代脱氧葡萄糖（18F-fluorodeoxyglucose, 18F-FDG）正电子发射断层显像/计算机断层扫描（positron emission tomography/computed tomography, PET/CT）在拟接受新辅助化疗的Ⅲ期非小细胞肺癌（non-small-cell lung cancer, NSCLC）患者中的预测及预后价值。

患者与方法：
回顾性纳入2013年3月至2017年12月期间接受诱导化疗的66例Ⅲ期非小细胞肺癌患者。疗效评估依据实体瘤疗效评价标准（Response Evaluation Criteria in Solid Tumors, RECIST）1.1版及欧洲癌症研究与治疗组织（European Organisation for Research and Treatment of Cancer, EORTC）标准进行。针对原发肿瘤（T）及区域淋巴结（N），分析18F-FDG PET/CT代谢参数的绝对值及两次连续扫描间的百分比变化量（Δ）。基于中位随访时长9.4个月，比较所有临床变量与代谢参数与治疗疗效的相关性，并分析其与无进展生存期（progression-free survival, PFS）及总生存期（overall survival, OS）的关联。

结果：
诱导治疗后，原发肿瘤的最大标准化摄取值（standardized uptake value max, SUVmax_T）、平均标准化摄取值（standardized uptake value mean, SUVmean_T）、代谢肿瘤体积（metabolic tumor volume, MTV_T）及肿瘤总病灶糖酵解量（total lesion glycolysis, TLG_T）在应答者与非应答者间存在显著差异（分别为6.6 vs. 13.8；P = 0.001；4.2 vs. 8.1；P < 0.001；6 vs. 17.9；P = 0.002；24.1 vs. 136.3；P < 0.001）。同样，两组间的百分比变化量（Δ_T）亦存在显著差异（P < 0.001）。除原发肿瘤外，区域淋巴结的术后最大标准化摄取值（standardized uptake value max, SUVmax_N）、术后平均标准化摄取值（standardized uptake value mean, SUVmean_N）及术后总病灶糖酵解量（total lesion glycolysis, TLG_N）（分别对应P = 0.024、P = 0.015及P = 0.024），以及所有百分比变化量（Δ_N）在应答者与非应答者间均存在差异。RECIST 1.1与EORTC疗效分类在27例患者中存在不一致（40.9%；κ=0.265；P = 0.003）。多变量分析显示，术后TLG_N是无进展生存期与总生存期的独立预测因子，而RECIST 1.1仅为总生存期的预测因子。

结论：
多项代谢参数可区分Ⅲ期非小细胞肺癌患者新辅助化疗后的应答者与非应答者。与RECIST 1.1相比，EORTC标准似乎更适用于治疗疗效评估。最后，术后TLG_N具有显著的预后评估价值。