For newly diagnosed patients, the impact of PET on their primary staging and treatment planning was also significant. PET results led to patients staged differently from conventional (i.e., CT) staging in 42% of the 153 patients. Stage IV disease was found in 11% of those patients thought to have either stage I or stage II disease under conventional staging. Nineteen patients (24%) thought to have stage III disease were found post-PET to be at stage IV.
Treatment planning for the newly diagnosed was also impacted. The study authors noted that the PET scan had a high impact (i.e., changed planned treatment) for 35% of the patients. Reflecting the large number of those with upstaged disease, 54 patients had their planned therapy change from curative to palliative, whereas for 6 patients, the planned therapy moved from palliative to curative. The PET results had a medium impact on 25% of the newly diagnosed patients. These changes were mostly in the area of radiation treatment.
According to the authors, because of its ability to more accurately stage disease compared with convention evaluation, PET also demonstrated its ability to produce accurate prediction of survival among patients.
"The impact of PET on patient care and well-being cannot be overstated," said author Rodney Hicks. "By allowing patients with a poor prognosis to receive palliative rather than futile curative therapy, the patient is spared the often harrowing effects of the treatments. The costs are also reduced as unproductive treatments are reduced."
Lung cancer is the most common cause of cancer death in western society, and is increasing in incidence. In the United States, the American Cancer Society estimates that 164,000 Americans were diagnosed with the disease in 2000, and an estimated 156,900 died, the largest number of deaths of any single cancer.
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Contact: Karen Lubieniecki
karenlub@aol.com
703-683-0357
Society of Nuclear Medicine
5-Nov-2001