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Is there a role for post-treatment PET/CT following chemoRT for Stage III NSCLC?
The NCCN guidelines discourage the use of PET/CT surveillance but the recent analysis of RTOG 0235 found post-CRT PET uptake to be associated with worse LRC. Is this something we should be looking at in order to select out patients for early salvage therapy?
Answer from: Radiation Oncologist at Academic Institution
The data from RTOG 0235 are certainly intriguing, but I don't think we have sufficient information to employ this in routine clinical practice.In fact, I think there are quite a few challenges, including, but not limited to:1. What is the true sensitivity for post-CRT PET/CT for LR failure? This wa...
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Answer from: Radiation Oncologist at Academic Institution
RTOG 0235/ACRIN 6668 demonstrated that in stage III patients treated with chemoradiation, elevated post-treatment SUV of regional lymph nodes, both the absolute value (SUVmax > 5.2) and the percentage of residual activity (>25.84%) compared to the pretreatment SUV were associated with inferior...
Answer from: Radiation Oncologist at Community Practice
For those of us not connected to RTOG trials, and familiar with 0235 and 1106 questions, eligibility, and status, simply stated, PET is expensive, and it needs to be medically necessary to get it. The first question in a patient treated with chemotherapy and radiotherapy for NSCLC, what will you do...