WCLC 2025 - Posters & ePosters-EP.07.43 The Role of FDG-PET/CT SUVmax in Predicting Treatment Outcomes and Progression Risk in SBRT for ES-NSCLC

EP.07.43 The Role of FDG-PET/CT SUVmax in Predicting Treatment Outcomes and Progression Risk in SBRT for ES-NSCLC

Pdf Summary

This retrospective study from Hospital Universitario 12 de Octubre in Madrid evaluated the predictive role of pre-treatment FDG-PET/CT maximum standardized uptake value (SUVmax) in early-stage non-small cell lung cancer (ES-NSCLC) patients treated with stereotactic body radiation therapy (SBRT) between 2016 and 2023. The investigators analyzed data from 49 patients, mostly male smokers, with a majority having peripheral tumors and pulmonary obstructive disease. They recorded tumor SUVmax, histological confirmation, radiotherapy regimens, and responses at three months post-SBRT, in addition to progression types and timing.<br /><br />The median follow-up was 1.5 years with a median progression-free survival of 1 year. Disease progression occurred in 23 patients; about half experienced local or nodal progression, while the rest developed distant metastases. The key finding was that lesion SUVmax values did not correlate significantly with progression risk (p=0.3), indicating SUVmax alone may not predict treatment outcomes or progression after SBRT in ES-NSCLC. However, patients who had stable disease on first follow-up exhibited significantly lower baseline SUVmax (mean 7.6 vs. higher values, p=0.04). Notably, 60% of these stable cases lacked histological proof of malignancy, suggesting some lesions may have been benign and potentially overtreated.<br /><br />No significant differences in progression patterns or response were linked to radiation fractionation schemes. The results imply that low SUVmax in stable lesions post-SBRT may indicate overtreatment of non-malignant lesions, and SUVmax alone is insufficient for predicting progression risk. The authors recommend further focused studies to clarify the value of SUVmax in guiding treatment decisions for ES-NSCLC.

Asset Subtitle

Gloria Guardia

Meta Tag

Speaker Gloria Guardia

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

FDG-PET/CT

SUVmax

early-stage non-small cell lung cancer

ES-NSCLC

stereotactic body radiation therapy

SBRT

tumor progression

progression-free survival

radiotherapy fractionation

overtreatment