ISSN: 1859 - 2872
Prognostic value of baseline 18F-FDG PET/CT metabolic parameters in patients with non-small cell lung cancer treated with pembrolizumab
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Abstract
Objective: To evaluate the prognostic value of metabolic parameters on ¹⁸F-FDG PET/CT, including SUVmax, MTV, and TLG, in relation to treatment outcomes in patients with stage IV non-small cell lung cancer (NSCLC) receiving Pembrolizumab. Subject and method: This retrospective study was conducted at Bach Mai Hospital and Hanoi Oncology Hospital from October 2018 to December 2025, including 45 patients with stage IV NSCLC treated with Pembrolizumab. All patients underwent ¹⁸F-FDG PET/CT prior to treatment. Metabolic parameters of the primary tumor, including SUVmax (maximum Standardized uptake value), MTV (Metabolic tumor volume), and TLG (Total lesion glycolysis), were measured. Optimal cut-off values were determined using receiver operating characteristic (ROC) curve analysis. Survival outcomes were analyzed using the Kaplan-Meier method and univariate and multivariate Cox proportional hazards regression models. Result: The median progression-free survival (PFS) was 9 months, and the median overall survival (OS) was 19 months. MTV and TLG were significantly associated with both PFS and OS (p<0.05), whereas SUVmax showed no prognostic significance. In multivariate Cox regression analysis, MTV was identified as an independent prognostic factor for PFS (HR = 2.275, p=0.013) and OS (HR = 4.275, p=0.006). TLG was also an independent predictor of PFS (HR = 3.158, p=0.007) and OS (HR = 3.664, p=0.012). In addition, treatment line was found to be a significant prognostic factor. Conclusion: Volumetric metabolic tumor parameters, particularly MTV and TLG measured on pre-treatment ¹⁸F-FDG PET/CT, demonstrated independent prognostic value for PFS and OS in patients with stage IV NSCLC treated with Pembrolizumab.
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References
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