Changes in glucose metabolism during and after radiotherapy in non-small cell lung cancer

Giampiero Giovacchini, Maria Picchio, Stefano Schipani, Claudio Landoni, Luigi Gianolli, Valentino Bettinardi, Nadia Di Muzio, Maria Carla Gilardi, Ferruccio Faziot, Cristina Messa

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Abstract

Aims and background. Evaluation of the metabolic response to radiotherapy in non- small cell lung cancer patients is commonly performed about three months after the end of radiotherapy. The aim of the present study was to assess with positron emission tomography/computed tomography (PET/CT) and [ 18F]fluorodeoxyglucose changes in glucose metabolism during and after radiotherapy in non-small cell lung cancer patients. Methods and study design. In 6 patients, PET/CT scans with [ 18F]luorodeoxyglucose were performed before (PET 0), during (PET 1 at a median of 14 days before the end of radiotherapy) and after the end of radiotherapy (PET 2 and PET 3, at a median of 28 and 93 days, respectively). The metabolic response was scored according to visual and semiquantitative criteria. Results. Standardize maximum uptake at PET 1 (7.9 ± 4.8), PET 2 (5.1 ± 4.1) and PET 3 (2.7 ± 3.1) were all significantly (P 0 (16.1 ± 10.1). Standardized maximum uptake at PET, was significantly higher than at both PET 2 and PET 3. There were no significant differences in SUV miX between PET 2 and PET 3. PET 3 identified 4 complete and 2 partial metabolic responses, whereas PET 1 identified 6 partial metabolic responses. Radiotherapy-induced increased [ 18Fl]luorodeoxyglucose uptake could be visually distinguished from tumor uptake based on PET/CT integration and was less frequent at PET 1 (n = 2) than at PET 3 (n 6). Conclusions. In non-small cell lung cancer, radiotherapy induces a progressive decrease in glucose metabolism that is greater 3 months after the end of treatment but can be detected during the treatment itself. Glucose avid, radiotherapy-induced inflammation is more evident after the end of radiotherapy than during radiotherapy and does not preclude the interpretation of 1'8Flfluorodeoxyglucose images, particularly when using PET/CT.

Original languageEnglish
Pages (from-to)177-184
Number of pages8
JournalTumori
Volume95
Issue number2
Publication statusPublished - Mar 2009

Keywords

  • Lung cancer
  • Positron- emission tomography
  • Radiotherapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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    Giovacchini, G., Picchio, M., Schipani, S., Landoni, C., Gianolli, L., Bettinardi, V., Muzio, N. D., Gilardi, M. C., Faziot, F., & Messa, C. (2009). Changes in glucose metabolism during and after radiotherapy in non-small cell lung cancer. Tumori, 95(2), 177-184.