Identify 18-Fluorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography (PET-CT) parameters predictive of tumor response and local control

The identification of robust prognostic and predictive markers could allow the individualization of pulmonary stereotactic radiotherapy treatments and the selection of patients at high risk of relapse, who could then benefit from a dose escalation in order to increase the chances of local control .

Beyond the pulmonary RTS (Radiotherapy in stereotactic condition), this study will aim to generate one or more models of multi-scale response to hypofractionated irradiation from biomarkers (biological or images) extracted from preclinical or clinical literature data and to allow simulations of Various modified fractionation irradiation schemes, potentially leading to new regimens that reduce side effects and increase therapeutic efficacy.

Inclusion Criteria:

• Age> 18 years
• Performance Index WHO (World Health Organization) ≤ 2
• Bronchopulmonary carcinoma not in small cells proved histologically or cytologically (epidermoid, adenocarcinoma, or large cell carcinoma).
• Tumor classified T1 - T2 (Tumor=1-2) N0 (Node=0) M0 (Metastasis=0) and diameter ≤ 5 cm or Tumor classified T3 (≤5cm) N0M0 of the chest wall
• Tumor located more than 2 cm from the trachea and bronchus stem and more than 1.5 cm from the organs at risk
• Medically inoperable or refusing surgery
• Indication of stereotactic radiotherapy validated in multidisciplinary consultation meeting
• Formulation of consent

Exclusion Criteria:

• Age <18 years.
• History of pulmonary irradiation
• Pulmonary surgery of the tumor
• Different histology of non-small cell carcinoma
• Patient with a T2 or T3> 5 cm tumor or patients with a T3 tumor invading a structure other than the chest wall
• Patient with a tumor within 2 cm of the trachea and bronchus stem and within 1.5 cm of the organs at risk in the proximal area of the no fly zone (defined as a volume Located 2 cm in all directions of the proximal bronchial tree - Pulmonary metastases
• Declared pregnancy, breast-feeding
• Refusal to use effective contraception
• Against indication to the realization of the PET to the 18FDG (18-fluorodeoxyglucose)(uncontrolled diabetes)
• Refusal or inability to consent to participate in the study.
• Estimated life expectancy <2 months in the absence of treatment
• Other invasive tumors diagnosed in the previous 2 years, with the exception of non-melanocytic cutaneous carcinomas.

All major patients requiring stereotactic radiotherapy for non-small cell bronchopulmonary carcinoma.