Intratumoral metabolic heterogeneity can be useful to select patients for radiotherapy dose-escalation in stage III non-small cell lung cancer

1390 Objectives We evaluated the value of intratumoral metabolic heterogeneity assessed using area under the curve of cumulative SUV-volume histogram (AUC-CSH) in FDG PET/CT to select patients for radiotherapy dose-escalation in patients with inoperable stage III non-small cell lung cancer (NSCLC). Methods Fifty-nine patients with inoperable stage III NSCLC, who underwent pretreatment FDG PET/CT before starting concurrent chemoradiotherapy between 2005 and 2012 were retrospectively reviewed (60 Gy: 27; 66 or 70 Gy: 32). For the classification of metabolic heterogeneity of primary tumor, median value of AUC-CSH was used. Progression-free survival (PFS), locoregional recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) curves were produced using Kaplan-Meier methods and survival difference between groups was assessed by Wilcoxon test. Results Twenty-seven patients had metabolically homogeneous primary tumors (AUC-CSH\u003e4489) and 32 patients had heterogeneous tumors (AUC-CSH Conclusions This preliminary study suggests that radiotherapy dose-escalation in concurrent chemoradiotherapy can improve PFS and LRFS not in the patients with metabolically heterogeneous primary lung tumor but in the patients with homogeneous tumor.