Impact of FDG-PET findings on decisions regarding patient management strategies: a multicenter trial in patients with lu
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ORIGINAL ARTICLE
Impact of FDG-PET findings on decisions regarding patient management strategies: a multicenter trial in patients with lung cancer and other types of cancer Kazuo Kubota1 • Shinsuke Matsuno2 • Nobuo Morioka3 • Shuji Adachi4 • Mitsuru Koizumi5 • Hikaru Seto6 • Motohisa Kojo7 • Satoshi Nishioka8 • Michihiko Nishimura9 • Hiroshi Yamamoto10
Received: 29 September 2014 / Accepted: 12 March 2015 The Author(s) 2015. This article is published with open access at Springerlink.com
Abstract Objective To date, numerous studies have been conducted on the diagnostic capabilities of positron emission tomography using [18F]-fluorodeoxyglucose (FDG-PET). However, no studies designed to evaluate the influence of FDG-PET on the selection of patient management strategies within the Japanese healthcare system have been reported to date. The aim of the present study was to investigate prospectively the proportion of patients whose management strategies were modified based on FDG-PET findings (strategy modification rate). Methods The strategy modification rate was calculated by comparing the patient management strategy (test and treatment plans) after FDG-PET with the strategy before FDG-PET for 560 cancer patients with nine types of cancer (lung cancer, breast cancer, colorectal cancer, head/neck cancer, brain tumor, pancreas cancer, malignant lymphoma, cancer of unknown origin, and melanoma). In addition, the details of the modifications to the patient management strategies were analyzed. & Kazuo Kubota [email protected] 1
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Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan Department of Radiology, Takinomiya General Hospital, 486 Takinomiya, Ayagawa Town, Ayauta, Kagawa 761-2305, Japan Department of Radiology, Matsue Red Cross Hospital, 200 Horomachi, Matsue, Shimane 690-0886, Japan
4
Department of Radiology, Hyogo Cancer Center, 13-70 Kitaojimachi, Akashi, Hyogo 673-0021, Japan
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Department of Nuclear Medicine, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo 135-0063, Japan
Results The strategy modification rate for patients with lung cancer was 71.6 % (149 of 208 patients, 95 % confidence interval 65.0–77.7 %), which was higher than previously reported strategy modification rates for lung cancer before and after FDG-PET (25.6 %). The strategy modification rates for patients with cancers other than lung cancer were as follows: breast, 44.4 % (56/126); colorectal, 75.6 % (62/82); head and neck, 65.2 % (15/23); malignant lymphoma, 70.0 % (35/50); pancreas, 85.0 % (17/20); and cancer of unknown origin, 78.0 % (32/41). The mean modification rate (major and minor modifications) of the treatment plans after FDG-PET, relative to the plans before FDG-PET, was 55.4 % (range 44.0–69.2 %), with major modifications pertaining to the treatment plan made in 43.3–68.2 % of the patients based on the objectives of the FDG-PET examination. Conclusions The results from this study indicate that FDG-PET ca
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