The Comparison Of ¹⁸F-Alfatide PET/CT And ¹⁸F-FDG PET/CT In Predicting Chemoradiotherapy Sensitivity In Patients With Advanced Non-small Cell Lung Cancer

BackgroundLung cancer is the leading cause of cancer death worldwide,80%–85% of lung cancer cases are classified as non-small cell lung cancer（NSCLC）.Approximately one-third of newly diagnosed NSCLC patients have been locally advanced disease and not amenable for curative resection.The main treatment of locally advanced NSCLC involves empirical platinum-based chemotherapy combination with radiotherapy（RT）,but part of these patients still experience local failure as their first site of relapse.In this term,the identification of factors that can predict chemoradiotherapy（CRT）sensitivity or monitor CRT response is highly important to personalize the treatment.This study aimed to compare the predictive value of ¹⁸F-Alfatide positron emission tomography/computed tomography（PET/CT）and ¹⁸F-fluorodeoxyglucose(¹⁸F-FDG)PET/CT in chemoradiotherapy（CRT）sensitivity of patients with advanced non-small cell lung cancer（NSCLC）.MethodsTwenty-four patients with advanced NSCLC accepted ¹⁸F-Alfatide PET/CT before radiotherapy（T1）,among them fourteen patients accepted it during CRT（40Gy of radiotherapy,T2）.Another thirty-nine patients underwent ¹⁸F-FDG PET/CT at both T1 and T2.Logistic regression analyse was used to evaluate the correlations between PET parameters and CRT sensitivity providing an odds ratio（OR）,95% confidence interval（CI）and P value.Propensity score matching（PSM）approach was used to control confounding.ResultsLogistic regression analyse showed that Karnofsky Performance Status（KPS）score was correlative with CRT sensitivity.After PSM,controlling KPS scores,twenty-four pairs of patients were matched.The results showed that SUVmax obtained from baseline ¹⁸F-Alfatide PET/CT was associated with CRT sensitivity in both univariate and multivariable logistic regression analysis（OR: 0.532,95% CI: 0.305–0.927,P=0.026;OR: 0.376,95% CI: 0.165-0.860,P=0.021）,but the baseline ¹⁸F-FDG PET/CT was not.Univariate analyses showed that the percent change in MTV of ¹⁸F-FDG PET/CT between T1 and T2 was correlative with CRT sensitivity（OR: 1.039,95% CI: 1.003-1.077,P=0.036）.When patients’ KPS score was considered simultaneously,it was still related to CRT sensitivity（OR: 1.038,95% CI: 1.001-1.077,P=0.045）.Conclusion¹⁸F-AlfatidePET/CT may be better than ¹⁸F-FDG PET/CT in predicting CRT sensitivity,and ¹⁸F-FDG PET/CT is potential in monitoring the tumor response to CRT in patients with advanced NSCLC.