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Impact of FDG-PET findings on decisions regarding patient management strategies: a multicenter trial in patients with lung cancer and other types of cancer.

Kubota K, Matsuno S, Morioka N, Adachi S, Koizumi M, Seto H, Kojo M, Nishioka S, Nishimura M, Yamamoto H - Ann Nucl Med (2015)

Bottom Line: In addition, the details of the modifications to the patient management strategies were analyzed.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).

View Article: PubMed Central - PubMed

Affiliation: Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan, kkubota@cpost.plala.or.jp.

ABSTRACT

Objective: To date, numerous studies have been conducted on the diagnostic capabilities of positron emission tomography using [(18)F]-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.

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 can contribute to the modification of management strategies (particularly treatment plans), especially for lung cancer patients but also for patients with other types of cancer.

No MeSH data available.


Related in: MedlinePlus

Flow of management strategy evaluation before and after FDG-PET
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Related In: Results  -  Collection


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Fig1: Flow of management strategy evaluation before and after FDG-PET

Mentions: Figure 1 illustrates the flow of the management strategy evaluation before and after FDG-PET. The percentage of patients whose management strategy as determined before FDG-PET was modified after FDG-PET (strategy modification rate) was analyzed. Investigators at each institution evaluated the management strategy. The parameters/indicators of the management strategy evaluation are shown in Table 2.Fig. 1


Impact of FDG-PET findings on decisions regarding patient management strategies: a multicenter trial in patients with lung cancer and other types of cancer.

Kubota K, Matsuno S, Morioka N, Adachi S, Koizumi M, Seto H, Kojo M, Nishioka S, Nishimura M, Yamamoto H - Ann Nucl Med (2015)

Flow of management strategy evaluation before and after FDG-PET
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4481297&req=5

Fig1: Flow of management strategy evaluation before and after FDG-PET
Mentions: Figure 1 illustrates the flow of the management strategy evaluation before and after FDG-PET. The percentage of patients whose management strategy as determined before FDG-PET was modified after FDG-PET (strategy modification rate) was analyzed. Investigators at each institution evaluated the management strategy. The parameters/indicators of the management strategy evaluation are shown in Table 2.Fig. 1

Bottom Line: In addition, the details of the modifications to the patient management strategies were analyzed.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).

View Article: PubMed Central - PubMed

Affiliation: Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan, kkubota@cpost.plala.or.jp.

ABSTRACT

Objective: To date, numerous studies have been conducted on the diagnostic capabilities of positron emission tomography using [(18)F]-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.

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 can contribute to the modification of management strategies (particularly treatment plans), especially for lung cancer patients but also for patients with other types of cancer.

No MeSH data available.


Related in: MedlinePlus