2088 - [¹⁸F]AlF-NOTA-QHY-04 PET/CT may Predict Short-Term Outcome for Patients with Limited-Stage Small Cell Lung Cancer Treated by Concurrent Chemoradiotherapy

J. Liu^1,2, S. Wang¹, K. Zhao¹, J. Yu³, and J. Liu¹; ¹Department of Radiation Oncology and Shandong Provincial Key Laboratory of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China, ²Department of Oncology, Renmin Hospital of Wuhan University, Wuhan, China, ³Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China

Purpose/Objective(s): The prospective study examined whether parameters obtained from the tracer targeting C-X-C motif chemokine receptor 4 (CXCR4) (denoted as [¹⁸F]AlF-NOTA-QHY-04) in positron emission tomography/computed tomography (PET/CT) could predict short-term outcome to concurrent chemoradiotherapy (CCRT) for patients with limited-stage small-cell lung cancer (LS-SCLC). Materials/

Methods: 23 eligible patients with LS-SCLC underwent [¹⁸F]AlF-NOTA-QHY-04 PET/CT scanning before CCRT. The maximum, mean, and peak standard uptake value (SUVmax, SUVmean, SUVpeak), metabolic tumor volume (MTV) and total lesion CXCR4 expression (TLC) of primary tumor were acquired. Tumor-to-background radio (TBRblood, TBRlung and TBRmuscle) were calculated according to the ratio of SUVmax of tumor to SUVmean of the normal tissue (blood, lung, and muscle). Patients were identified as responders and non-responders according to the revised RECIST criteria (v.1.1). Progression-free survival (PFS) was recorded and analyzed.
Results: The median follow-up time was 8.0 months (range, 2.87-13.45 months), and the median PFS was 7.77 months (95%CI, 2.80-13.30 months). SUVmax, SUVmean, SUVpeak, MTV, TLC, TBRlung, TBRblood, and TBRmuscle were significantly higher in non-responders than in responders (all P< 0.05). Regions of interest (ROI) curve analysis identify SUVmax (AUC=0.829, P=0.043), SUVmean (AUC=0.842, P=0.035), MTV (AUC=0.868, P=0.023), TLC (AUC=0.934, P=0.007), TBRlung (AUC=0.882, P=0.019), TBRblood (AUC=0.934, P=0.007), and TBRmuscle (AUC=0.921, P=0.009) as significant predictor for response to CCRT. According to univariate logistic regression analysis, TLC (P=0.046), TBRlung (P=0.045), TBRblood (P=0.024), and TBRmuscle (P=0.044) could predict the short-term response. Multivariable logistic regression analysis revealed TBRblood (P=0.045) as the significant predictor for short-term outcome, and patients with TBRblood =3.48 experienced prolonged PFS than those with TBR>3.48 significantly (HR=0.11, P=0.009) according to Kaplan-Meier curves.
Conclusion: The baseline [¹⁸F]AlF-NOTA-QHY-04 uptake on PET/CT may predict short-term outcome for LS-SCLC patients receiving CCRT, with higher tumor uptake predicting poor response and shorter PFS.