Follow-up with 18FDG-PET–CT after radical radiotherapy with or without chemotherapy allows the detection of potentially curable progressive disease in non-small cell lung cancer patients: A prospective study

BackgroundFollow-up of patients treated with curative intent for non-small cell lung cancer (NSCLC) with X-ray or CT-scans is of unproven value. Furthermore, most patients with progressive disease present with symptoms outside of follow-up visits. Because the accuracy of 18FDG-PET–CT is superior to CT, we hypothesised that FDG-PET–CT scans 3 months post-treatment could lead to early detection of progressive disease (PD) amenable for radical treatment.Patients and methodsHundred patients with NSCLC, treated with curative intent with (chemo) radiation, were prospectively evaluated. All patients underwent a planned FDG-PET–CT scan 3 months after the start of radiotherapy.ResultsTwenty four patients had PD 3 months post-treatment. 16/24 patients were symptomatic. No curative treatment could be offered to any of these patients. In 3/8 asymptomatic patients progression, potentially amenable for radical therapy was found, which were all detected with PET, not with CT only.ConclusionsPET-scanning after curative treatment for NSCLC led to the detection of progression potentially amenable for radical treatment in a small proportion (3%) of patients. Selectively offering a PET–CT scan to the patient group without symptoms could possibly lead to an effective follow-up method.