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13.10.2017 | Review Article

Predictive and prognostic value of tumor volume and its changes during radical radiotherapy of stage III non-small cell lung cancer

A systematic review

verfasst von: Lukas Käsmann, Maximilian Niyazi, Oliver Blanck, Christian Baues, René Baumann, Sophie Dobiasch, Chukwuka Eze, Daniel Fleischmann, Tobias Gauer, Frank A. Giordano, Yvonne Goy, Jan Hausmann, Christoph Henkenberens, David Kaul, Lisa Klook, David Krug, Matthias Mäurer, Cédric M. Panje, Johannes Rosenbrock, Lisa Sautter, Daniela Schmitt, Christoph Süß, Alexander H. Thieme, Maike Trommer-Nestler, Sonia Ziegler, Nadja Ebert, Daniel Medenwald, Dr. med. Christian Ostheimer, Young DEGRO Trial Group

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 2/2018

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Abstract

Purpose

Lung cancer remains the leading cause of cancer-related mortality worldwide. Stage III non-small cell lung cancer (NSCLC) includes heterogeneous presentation of the disease including lymph node involvement and large tumour volumes with infiltration of the mediastinum, heart or spine. In the treatment of stage III NSCLC an interdisciplinary approach including radiotherapy is considered standard of care with acceptable toxicity and improved clinical outcome concerning local control. Furthermore, gross tumour volume (GTV) changes during definitive radiotherapy would allow for adaptive replanning which offers normal tissue sparing and dose escalation.

Methods

A literature review was conducted to describe the predictive value of GTV changes during definitive radiotherapy especially focussing on overall survival. The literature search was conducted in a two-step review process using PubMed®/Medline® with the key words “stage III non-small cell lung cancer” and “radiotherapy” and “tumour volume” and “prognostic factors”.

Results

After final consideration 17, 14 and 9 studies with a total of 2516, 784 and 639 patients on predictive impact of GTV, GTV changes and its impact on overall survival, respectively, for definitive radiotherapy for stage III NSCLC were included in this review. Initial GTV is an important prognostic factor for overall survival in several studies, but the time of evaluation and the value of histology need to be further investigated. GTV changes during RT differ widely, optimal timing for re-evaluation of GTV and their predictive value for prognosis needs to be clarified. The prognostic value of GTV changes is unclear due to varying study qualities, re-evaluation time and conflicting results.

Conclusion

The main findings were that the clinical impact of GTV changes during definitive radiotherapy is still unclear due to heterogeneous study designs with varying quality. Several potential confounding variables were found and need to be considered for future studies to evaluate GTV changes during definitive radiotherapy with respect to treatment outcome.

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Titel: Predictive and prognostic value of tumor volume and its changes during radical radiotherapy of stage III non-small cell lung cancer
A systematic review
verfasst von: Lukas Käsmann
Maximilian Niyazi
Oliver Blanck
Christian Baues
René Baumann
Sophie Dobiasch
Chukwuka Eze
Daniel Fleischmann
Tobias Gauer
Frank A. Giordano
Yvonne Goy
Jan Hausmann
Christoph Henkenberens
David Kaul
Lisa Klook
David Krug
Matthias Mäurer
Cédric M. Panje
Johannes Rosenbrock
Lisa Sautter
Daniela Schmitt
Christoph Süß
Alexander H. Thieme
Maike Trommer-Nestler
Sonia Ziegler
Nadja Ebert
Daniel Medenwald
Dr. med. Christian Ostheimer
Young DEGRO Trial Group
Publikationsdatum: 13.10.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 2/2018
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-017-1221-y

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Predictive and prognostic value of tumor volume and its changes during radical radiotherapy of stage III non-small cell lung cancer

A systematic review