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Background: In this study,positron emission tomography-computed tomography ( PET-CT) was used to monitor the maximal standard uptake value ( SUVmax) in advanced lung adenocarcinoma patients with epithermal growth factor receptor ( EGFR) mutation as to prove its role in predicting the prognosis of the targeted therapy.Methods: A total of 46 patients with advanced lung adenocarcinoma ( IIIb - IV stage) were enrolled in the current study.They were positive for EGFR mutation.All patients received gefitinib (250 mg per day,administered orally).PET -CT was conducted prior to (at baseline) and 6 months after gefitinib administration for the lesion size and SUVmax.The recommendations of the E uropean Organization for Research and Treatment of Cancer ( EORTC) criteria were chosen for the PET assessment.Metabolic response ( SUV decline <-25%) was compared with morphologic response evaluated by CT scan and overall survival.Result: Compared to patients with △SUV% ≥ 25% (progressive metabolic disease),the survival time was significantly prolonged in △SUV% < ?25% (including complete metabolic response and progressive metabolic disease) (10.6/18.4,P = 0.000),but was not in ?25% ≤ △SUV% < 25% (stable metabolic disease) (10.6/10.7,P = 0.088).Patients who achieved △SUV%<-25% after treatment were associated with a longer median survival,higher control rate,and better prognosis.There was a strong correlation between SUV changes (△SUV%) and CT size change (△lesion size%) (R2 = 0.891,P = 0.000).Conclusion: Changes in the SUV could be used to predict the prognosis of targeted therapy in advanced lung adenocarcinoma.