Prognostic value of post-induction chemotherapy 18F-FDG PET-CT in stage II/III non-small cell lung cancer before (chemo-) radiation

INTRODUCTION

The purpose of our present study was to assess the prognostic impact of FDG PET-CT after induction chemotherapy for patients with inoperable non-small-cell lung cancer (NSCLC).

MATERIAL AND METHODS

This retrospective study included 50 patients with inoperable stage II/III NSCLC from January 2012 to July 2015. They were treated for curative intent with induction chemotherapy, followed by concomitant chemoradiation therapy or sequential radiation therapy. FDG PET-CT scans were acquired at initial staging (PET1) and after the last cycle of induction therapy (PET2). Five parameters were evaluated on both scans: SUVmax, SUVpeak, SUVmean, TLG, MTV, and their respective deltas. The prognostic value of each parameter for overall survival (OS) and progression-free survival (PFS) was evaluated with Cox proportional-hazards regression models.

RESULTS

Median follow-up was 19 months. PET1 parameters, clinical and histopathological data were not predictive of the outcome. TLG2 and ΔTLG were prognostic factors for OS. TLG2 was the only prognostic factor for PFS. For OS, log-rank test showed that there was a better prognosis for patients with TLG2< 69g (HR = 7.1, 95%CI 2.8-18, p = 0.002) and for patients with ΔTLG< -81% after induction therapy (HR = 3.8, 95%CI 1.5-9.6, p = 0.02). After 2 years, the survival rate was 89% for the patients with low TLG2 vs 52% for the others. We also evaluated a composite parameter considering both MTV2 and ΔSUVmax. Patients with MTV2> 23cc and ΔSUVmax> -55% had significantly shorter OS than the other patients (HR = 5.7, 95%CI 2.1-15.4, p< 0.01).

CONCLUSION

Post-induction FDG PET might be an added value to assess the patients' prognosis in inoperable stage II/III NSCLC. TLG, ΔTLG as well as the association of MTV and ΔSUVmax seemed to be valuable parameters, more accurate than clinical, pathological or pretherapeutic imaging data.

Influence of the Corticosterone Rhythm on Photic Entrainment of Locomotor Activity in Rats

The question of involvement of glucocorticoid hormones as temporal signals for the synchronization of the timekeeping system was addressed in rats with different corticosterone status. The authors showed that adrenalectomy had no effects on the synchronization of wheel-running activity rhythms to a steady-state LD 12:12 cycle, regardless of whether it was compensated for by a corticosterone replacement therapy that either reinstated constant plasma concentrations of the hormone or mimicked its natural rhythm. However, after a 12-h phase shift (daylight reversal), the lack of circulating corticosterone induced a significant shortening of the resynchronization rate (less than 3 days vs. 7 days). Normalization required restoration of a rhythmic corticosterone secretion that was synchronized to the new photoperiod. Under constant darkness, the corticosterone rhythm did not show any synchronizing effect, providing evidence that it participates in entrainment of the locomotor activity rhythm through modulation of light effects. It is proposed that, under stable lighting conditions, circulating glucocorticoids contribute to stabilizing activity rhythms by reinforcing resistance of the circadian timing system to variations of the photoperiod. Experimental evidence that serotonergic neurons are involved in relaying their modulatory effects to the clock is also presented.

Mid-infrared spectroscopy of erbium doped chloride laser crystals

We report on a spectroscopic analysis of ErCl3 and 1% Er 3+:YCl3 to determine their potential as possible laser sources at 3.5 and 4.5 mm. Concentration quenching of the low lying excited states is reported to be surprisingly very weak in this system. Although some shortening of the lifetimes is measured in the fully concentrated system, they retain lifetimes that are of order several milliseconds or more. A Judd-Ofelt analysis is performed and the projected gains for the 3.5 and 4.5 mm transitions are calculated. Successful growth techniques of erbium doped chlorides are also described.

[Epithelial and stromal healing after radial keratotomy. Scanning electron microscopy analysis]

A study of corneal healing after radial keratotomy was conducted under scanning electron microscopy in 28 papio-papio baboons. The appearance of the incisions after follow-ups ranging from one hour to three and a half years postoperatively permits to emit some hypotheses regarding the precise mechanisms of action of radial keratotomy, as well as those governing any functional or anatomical complications susceptible to occur after the operation.

Tuberculosis of the larynx: clinical aspects in 19 patients

Laryngeal tuberculosis continues to exist in spite of extensive tuberculosis eradication campaigns. We present 19 cases of laryngeal tuberculosis seen in our institution between 1982 and 1987. From the clinical findings it is clear that the localization of the lesions has changed since the preantibiotic era. Today the spread appears to be mainly via lymphatic and hematogenic routes, as opposed to the direct spread more common previously. The fibrosis caused by the lesions is incapacitating and frequently requires surgical correction.

[Endothelial effects of radial keratotomy in a non-human primate]

The study of the endothelial repercussion of radial keratotomy has been done on 33 corneas of 21 non human primates, using Scanning Electronic Microscope. Various lesions has been observed; the relationship between these lesions and the surgery parameters have been studied. One can conclude that the lesions are constant; their severity is related to the number and the depth of the incisions; as for their evolution, they do not seem to worsen with time during the experimental study (1 hour to 18 months).