PET changes staging and treatment for newly diagnosed and recurrent lung cancer patients

Reston, VirginiaPositron Emission Tomography (PET) can have a dramatic impact on patient staging and subsequent treatment of persons recently diagnosed or with suspected recurrent nonsmall cell lung cancer (NSCLC) according to two studies published in the November, 2001 issue of The Journal of Nuclear Medicine. One study of 63 patients with suspected recurring disease revealed that PET scans were significantly more accurate in identifying the extent of the possible recurrent disease for 86% of the patients, whereas conventional staging was correct for only 24% of the patients. In the same study PET scans found that 33% of the patients had less extensive disease and 37% had more extensive disease than conventional evaluation using computed tomography (CT) had suggested. In cases in of recurring cancer, in which the PET scan and CT findings differed, PET was found to be correct 86% of the time, while the conventional evaluation was correct for only one patient (3%).

The PET scan findings resulted in a major change in treatment for 63% of the patients with recurrent cancer. Of these, treatment for 6 patients was changed from curative to palliative care. More importantly, 9 persons who were going to receive either active palliative therapy or an invasive diagnostic procedure were spared these costly, and potentially painful treatments, when the PET scan revealed no active disease. Major changes were classified as changing the treatment intent or modality, i.e., from palliative to curative treatment or from surgery to radiotherapy. PET had a medium impact on management of 8 patients (13%), which generally meant changes in radiation treatment volume. It had a low impact on 13 patients (21%).

Telling people they are free of active disease has an enormously reassuring psychological impact on patients, and therefore we felt that this resultwhile often overlookedqualified it as a major impact of the PET study results, stated study author Dr. Rodney J. Hic

Contact: Karen Lubieniecki
Society of Nuclear Medicine

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