Resumen de Valor pronóstico de parámetros cuantitativos de la PET/TC con [18F]FDG en pacientes con carcinoma no microcítico de pulmón tratados con radioterapia estereotáctica corporal
Objetivos: Estudiar el valor pronóstico de los parámetros metabólicos cuantitativos volumétricos de la PET/CT con [18F]FDG en pacientes tratados con SBRT por carcinoma no microcítico de pulmón (CPNM).
Material y métodos: Análisis retrospectivo de 65 pacientes estadios T1 y T2 N0 M0 de la AJCC estadificados mediante PET/CT. Los parámetros metabólicos cuantificados: SUVmáx, MTV y TLG. Estos dos últimos parámetros se calcularon con diferentes umbrales de isocontorno 3D basados en un SUVmáx de 2, 2,5 y 3, así como un SUV correspondiente al 30%, 40% y 50% del máximo; conjuntamente se estudiaron variables tumorales, clínicas y dosimétricas.
Resultados. Se trataron 65 pacientes (71 lesiones tumorales) entre enero 2011 y septiembre de 2019. Seguimiento medio fue de 40,6 meses. La supervivencia global media fue de 50,38 meses. La dosis media (BED10) administrada fue de 112,88 Gy. En el análisis multivariante las variables relacionadas con los indicadores estudiados fueron: SUVmáx, MTV, MTV 2,5 y MTV 30 para supervivencia cáncer específica; MTV 2,5 para supervivencia libre de progresión; MTV 30 y ausencia de biopsia para el control local ; tipo histológico y tamaño tumoral para la recidiva regional; MTV 3, MTV 50 y tamaño tumoral para la recidiva a distancia. Ningún valor de TLG resultó asociado con indicadores de supervivencia.
Conclusión. SUVmáx y varios niveles de MTV fueron capaces de pronosticar la supervivencia de los pacientes según los diferentes objetivos de estudio; la determinación rutinaria de estos debería formar parte de la evaluación de los pacientes con CPNM estadio I tratados con SBRT.
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