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C. Faivre-Finn, F. Blackhall, M. Snee, S. Harsen, P. Hulse, et al., “Improving Survival with Thoracic Radiotherapy in Patients with Small Cell Lung Cancer. The CONVERT and the REST Trials,” Clinical Oncology (Royal College of Radiologists), Vol. 22, No. 7, 2010, pp. 547-549. doi:10.1016/j.clon.2010.05.008

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• TITLE: 18FDG-PET/CT Is a Useful Tool in Staging Procedure before Chemo-Radiotherapy in Patients with Limited Disease Small-Cell Lung Cancer. Pattern of Failure and Survival Is Analyzed

  AUTHORS: Anne Winther Larsen, Azza A. Khalil, Peter Meldgaard, Marianne M. Knap

  KEYWORDS: Small-Cell Lung Cancer; Limited Disease; Thoracic Radiotherapy; Positron Emission Tomography; Pattern of Failure

  JOURNAL NAME: Journal of Cancer Therapy, Vol.3 No.4A, September 12, 2012

  ABSTRACT: Background: The purpose of this study was to evaluate the use of 18FDG-PET/CT in staging procedure, the pattern of failure and survival in patients with small-cell lung cancer limited disease (LD-SCLC) undergoing chemo-radiotherapy. Methods: A total of 79 LD-SCLC patients were treated with a combination of chemotherapy and chest radiotherapy. Radiotherapy of the tumour and the pathological lymph nodes was performed either as 45 Gy twice-daily or 46 - 50 Gy once-daily. 18Fluro-2-deoxy-D-glucose (18FDG)-PET/CT was performed in 35 patients as part of the staging procedure. Results: With a median follow-up time of 17 months 6% developed isolated loco-regional failures while 57% developed distant metastases. No isolated regional failures were seen. Median overall survival was 22 months. Patients staged with a 18FDG-PET/CT had a significantly lower incidence of distant failures and a significantly improved overall survival compared with patients only staged with a CT scan (p = 0.03) (median overall survival of 34 versus 17 months, respectively). Conclusion: The pattern of failure showed a high risk of distant metastases but a low incidence of isolated loco-regional failures. Patients staged with an 18FDG-PET/CT had a significantly lower incidence of distant failures and better overall survival, indicating that 18FDG-PET could be beneficial in patients with LD-SCLC before deciding on treatment regimen.