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Erschienen in: Journal of Cancer Research and Clinical Oncology 6/2018

05.04.2018 | Original Article – Clinical Oncology

Is tumor volume reduction during radiotherapy prognostic relevant in patients with stage III non-small cell lung cancer?

verfasst von: Khaled Elsayad, Laith Samhouri, Sergiu Scobioala, Uwe Haverkamp, Hans Theodor Eich

Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 6/2018

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Abstract

Purpose/objective(s)

Lung cancer tumor volume reduction is common during radiation treatment (RT). The purpose of this study was to investigate tumor volume reduction ratio (VRR) and its correlation with outcomes in a cohort of patients with stage III non-small cell lung cancer (NSCLC) who underwent image-guided radiochemotherapy (RCTx).

Materials/methods

Fifty patients with NSCLC treated with fractionated RT at our institution between 2013 and 2017 were included. The relationship between gross tumor volume (GTV) changes during RT (week 1 vs. week 5) and outcomes were evaluated.

Results

The median radiation dose delivered was 59.4 Gy (median fraction dose, 1.8 Gy). The median GTV before treatment was 119 cm3, with a median GTV change of − 40%. Patients with more volume reduction had poorer tumor control. A VRR > 40% was associated with a poorer OS and PFS in patients with non-adenocarcinoma (non-ADC) histology. In multivariate analysis, VRR during RT, and chemotherapy (CTx) administration remained related to PFS and OS, while initial GTV remained a significant determinant for OS. In subgroup analyses, and CTx (p = 0.038) affected PFS among non-ADC patients, with initial GTV (p = 0.058) and VRR (p = 0.08) showing non-significant trends. Initial GTV (p = 0.023), VRR (p = 0.038), and CTx (p = 0.01) remained significant predictors for OS in the non-ADC group.

Conclusion

Worse tumor control and OS in non-ADC patients are observed with more marked RT-induced tumor shrinkage, supporting the development of response-adaptive treatment strategies, particularly in non-ADC NSCLC patients.
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Metadaten
Titel
Is tumor volume reduction during radiotherapy prognostic relevant in patients with stage III non-small cell lung cancer?
verfasst von
Khaled Elsayad
Laith Samhouri
Sergiu Scobioala
Uwe Haverkamp
Hans Theodor Eich
Publikationsdatum
05.04.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Journal of Cancer Research and Clinical Oncology / Ausgabe 6/2018
Print ISSN: 0171-5216
Elektronische ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-018-2640-6

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