[article] 
inMÉDECINE NUCLÉAIRE > Vol. 43, n° 2 (Mars/Avril 2019) . - p. 180

Titre :	Long-time follow-up of radiotherapy boost in patients with lung cancer based on FMISO PET: Can we expect a better survival outcome? (RTEP5 3 years follow-up)
Type de document :	texte imprimé
Auteurs :	P. Vera ; S.D. Mihailescu ; J. Lequesne ; R. Modzelewski ; P. Bohn ; Hapdey ; P. Chaumet Riffaud ; Jean Marie Decazes ; S. Thureau
Année de publication :	2019
Article en page(s) :	p. 180
Note générale :	Doi : 10.1016/j.mednuc.2019.01.019
Langues :	Anglais (eng)
Mots-clés :	ONCOLOGIE  POUMON CANCER  18F-FMISO
Résumé :	Background Chemoradiotherapy is the reference curative-intent treatment for nonresectable locally advanced non-small-cell lung carcinoma (NSCLC), with unsatisfying survival partially due to radiation resistance in hypoxic tissues, raising the question of targeted radiotherapy. Objective To evaluate the risk-benefit of radiotherapy boost on hypoxic tumors in NSCLC patients treated by curative-intent chemoradiotherapy in an open-label, nonrandomized, phase II clinical trial developed from 2012 to 2015 with a 3-year follow-up. Multicenter study performed in 15 French academic centers (NCT01576796). Participants: eligible patients had locally advanced NSCLC and no contraindication to concomitant chemoradiotherapy. Seventy-nine patients underwent a run-in period, of which 54 were included. Twenty-four patients completed the study at 3 years. 18F-fluoromisonidazole (18F-MISO) positron emission tomography/computed tomography was performed to determine the hypoxic profile of patients (34 positive and 20 negative). Those with positive 18F-FMISO status and without organ-at-risk constraints (n=24) received radiotherapy boost (70–84Gy); the others received standard radiotherapy (66Gy). Overall survival (OS), progression-free survival (PFS), and safety. Hypotheses tested were formulated before data collection. Results: fifty-four patients were evaluated, with a median age of 61 (41–76) years. OS and PFS rates at 1, 2, and 3years were, respectively, 87%, 58.2%, and 48.5%, and 59.3%, 36.4%, and 28.8%. The median OS in the positive 18F-FMISO group was 25.8months and was not reached at 3years in the negative (P=0.01). A difference was also observed for PFS (12 vs. 26.2months, P=0.048). By focusing on positive 18F-FMISO patients, no difference was observed in OS according to the dose, probably because of the small sample size (P=0.30). However, the median OS seemed to be in favor of boosted patients (26.5 vs. 15.3months, P=0.71). In patients who underwent boost, no significant early or late toxicities were observed. Conclusions and relevance 18F-FMISO uptake in NSCLC patients is strongly associated with poor prognosis features. In the group of 18F-FMISO-positive patients, radiotherapy boost seems to improve the OS by 11.2months. These results deserve further attention in a future clinical trial devoted to hypoxic patients to confirm boost efficacy.
Note de contenu :
Permalink :	http://cdocs.helha.be/pmbgilly/opac_css/index.php?lvl=notice_display&id=63052

[article] Long-time follow-up of radiotherapy boost in patients with lung cancer based on FMISO PET: Can we expect a better survival outcome? (RTEP5 3 years follow-up) [texte imprimé] / P. Vera ; S.D. Mihailescu ; J. Lequesne ; R. Modzelewski ; P. Bohn ; Hapdey ; P. Chaumet Riffaud ; Jean Marie Decazes ; S. Thureau . - 2019 . - p. 180.
Doi : 10.1016/j.mednuc.2019.01.019
Langues : Anglais (eng)
in MÉDECINE NUCLÉAIRE > Vol. 43, n° 2 (Mars/Avril 2019) . - p. 180

Mots-clés :	ONCOLOGIE  POUMON CANCER  18F-FMISO
Résumé :	Background Chemoradiotherapy is the reference curative-intent treatment for nonresectable locally advanced non-small-cell lung carcinoma (NSCLC), with unsatisfying survival partially due to radiation resistance in hypoxic tissues, raising the question of targeted radiotherapy. Objective To evaluate the risk-benefit of radiotherapy boost on hypoxic tumors in NSCLC patients treated by curative-intent chemoradiotherapy in an open-label, nonrandomized, phase II clinical trial developed from 2012 to 2015 with a 3-year follow-up. Multicenter study performed in 15 French academic centers (NCT01576796). Participants: eligible patients had locally advanced NSCLC and no contraindication to concomitant chemoradiotherapy. Seventy-nine patients underwent a run-in period, of which 54 were included. Twenty-four patients completed the study at 3 years. 18F-fluoromisonidazole (18F-MISO) positron emission tomography/computed tomography was performed to determine the hypoxic profile of patients (34 positive and 20 negative). Those with positive 18F-FMISO status and without organ-at-risk constraints (n=24) received radiotherapy boost (70–84Gy); the others received standard radiotherapy (66Gy). Overall survival (OS), progression-free survival (PFS), and safety. Hypotheses tested were formulated before data collection. Results: fifty-four patients were evaluated, with a median age of 61 (41–76) years. OS and PFS rates at 1, 2, and 3years were, respectively, 87%, 58.2%, and 48.5%, and 59.3%, 36.4%, and 28.8%. The median OS in the positive 18F-FMISO group was 25.8months and was not reached at 3years in the negative (P=0.01). A difference was also observed for PFS (12 vs. 26.2months, P=0.048). By focusing on positive 18F-FMISO patients, no difference was observed in OS according to the dose, probably because of the small sample size (P=0.30). However, the median OS seemed to be in favor of boosted patients (26.5 vs. 15.3months, P=0.71). In patients who underwent boost, no significant early or late toxicities were observed. Conclusions and relevance 18F-FMISO uptake in NSCLC patients is strongly associated with poor prognosis features. In the group of 18F-FMISO-positive patients, radiotherapy boost seems to improve the OS by 11.2months. These results deserve further attention in a future clinical trial devoted to hypoxic patients to confirm boost efficacy.
Note de contenu :
Permalink :	http://cdocs.helha.be/pmbgilly/opac_css/index.php?lvl=notice_display&id=63052