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Early treatment volume reduction rate as a prognostic factor in patients treated with chemoradiotherapy for limited stage small cell lung cancer.

Lee J, Lee J, Choi J, Kim JW, Cho J, Lee CG - Radiat Oncol J (2015)

Bottom Line: Early treatment volume reduction rate (ETVRR) was defined as the percentage change in gross tumor volume between diagnostic computed tomography (CT) and simulation CT for adaptive RT planning and was used as a parameter for early treatment response.The mean diagnostic and adaptive gross tumor volumes were 117.9 mL (range, 5.9 to 447 mL) and 36.8 mL (range, 0.3 to 230.6 mL), respectively.ETVRR as a parameter for early treatment response may be a useful prognostic factor to predict treatment outcome in LS-SCLC patients treated with CRT.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To investigate the relationship between early treatment response to definitive chemoradiotherapy (CRT) and survival outcome in patients with limited stage small cell lung cancer (LS-SCLC).

Materials and methods: We retrospectively reviewed 47 patients with LS-SCLC who received definitive CRT between January 2009 and December 2012. Patients were treated with systemic chemotherapy regimen of etoposide/carboplatin (n = 15) or etoposide/cisplatin (n = 32) and concurrent thoracic radiotherapy at a median dose of 54 Gy (range, 46 to 64 Gy). Early treatment volume reduction rate (ETVRR) was defined as the percentage change in gross tumor volume between diagnostic computed tomography (CT) and simulation CT for adaptive RT planning and was used as a parameter for early treatment response. The median dose at adaptive RT planning was 36 Gy (range, 30 to 43 Gy), and adaptive CT was performed in 30 patients (63.8%).

Results: With a median follow-up of 27.7 months (range, 5.9 to 75.8 months), the 2-year locoregional progression-free survival (LRPFS) and overall survival (OS) rates were 74.2% and 56.5%, respectively. The mean diagnostic and adaptive gross tumor volumes were 117.9 mL (range, 5.9 to 447 mL) and 36.8 mL (range, 0.3 to 230.6 mL), respectively. The median ETVRR was 71.4% (range, 30 to 97.6%) and the ETVRR >45% group showed significantly better OS (p < 0.0001) and LRPFS (p = 0.009) than the other group.

Conclusion: ETVRR as a parameter for early treatment response may be a useful prognostic factor to predict treatment outcome in LS-SCLC patients treated with CRT.

No MeSH data available.


Related in: MedlinePlus

Kaplan-Meier survival curves of 47 patients: (A) overall survival, (B) progression-free survival, (C) locoregional progression-free survival and (D) distant metastasis-free survival.
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Figure 1: Kaplan-Meier survival curves of 47 patients: (A) overall survival, (B) progression-free survival, (C) locoregional progression-free survival and (D) distant metastasis-free survival.

Mentions: Five patients (10.6%) achieved a complete response, 40 patients achieved a partial response (85.1%), and two patients had stable disease (4.3%). With a median follow-up time of 27.4 months (range, 6.2 to 66.4 months), the 2-year LRPFS and DMFS rates were 74.2% and 70.1%, respectively. Two-year PFS and OS rates were 50.6% and 56.5%, respectively (Fig. 1). Of the total patients, 17 (36.2%) experienced locoregional failure, 17 (36.2%) had distant failure, and seven (14.9%) had both. Sites of distant failure included brain (n = 9), bone (n = 2), adrenal gland (n = 2), liver (n = 2), and intra-abdominal LNs including the para-aortic area (n = 1). One patient had multifocal sites, including the brain, left seventh rib, and LN around the celiac trunk.


Early treatment volume reduction rate as a prognostic factor in patients treated with chemoradiotherapy for limited stage small cell lung cancer.

Lee J, Lee J, Choi J, Kim JW, Cho J, Lee CG - Radiat Oncol J (2015)

Kaplan-Meier survival curves of 47 patients: (A) overall survival, (B) progression-free survival, (C) locoregional progression-free survival and (D) distant metastasis-free survival.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493423&req=5

Figure 1: Kaplan-Meier survival curves of 47 patients: (A) overall survival, (B) progression-free survival, (C) locoregional progression-free survival and (D) distant metastasis-free survival.
Mentions: Five patients (10.6%) achieved a complete response, 40 patients achieved a partial response (85.1%), and two patients had stable disease (4.3%). With a median follow-up time of 27.4 months (range, 6.2 to 66.4 months), the 2-year LRPFS and DMFS rates were 74.2% and 70.1%, respectively. Two-year PFS and OS rates were 50.6% and 56.5%, respectively (Fig. 1). Of the total patients, 17 (36.2%) experienced locoregional failure, 17 (36.2%) had distant failure, and seven (14.9%) had both. Sites of distant failure included brain (n = 9), bone (n = 2), adrenal gland (n = 2), liver (n = 2), and intra-abdominal LNs including the para-aortic area (n = 1). One patient had multifocal sites, including the brain, left seventh rib, and LN around the celiac trunk.

Bottom Line: Early treatment volume reduction rate (ETVRR) was defined as the percentage change in gross tumor volume between diagnostic computed tomography (CT) and simulation CT for adaptive RT planning and was used as a parameter for early treatment response.The mean diagnostic and adaptive gross tumor volumes were 117.9 mL (range, 5.9 to 447 mL) and 36.8 mL (range, 0.3 to 230.6 mL), respectively.ETVRR as a parameter for early treatment response may be a useful prognostic factor to predict treatment outcome in LS-SCLC patients treated with CRT.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To investigate the relationship between early treatment response to definitive chemoradiotherapy (CRT) and survival outcome in patients with limited stage small cell lung cancer (LS-SCLC).

Materials and methods: We retrospectively reviewed 47 patients with LS-SCLC who received definitive CRT between January 2009 and December 2012. Patients were treated with systemic chemotherapy regimen of etoposide/carboplatin (n = 15) or etoposide/cisplatin (n = 32) and concurrent thoracic radiotherapy at a median dose of 54 Gy (range, 46 to 64 Gy). Early treatment volume reduction rate (ETVRR) was defined as the percentage change in gross tumor volume between diagnostic computed tomography (CT) and simulation CT for adaptive RT planning and was used as a parameter for early treatment response. The median dose at adaptive RT planning was 36 Gy (range, 30 to 43 Gy), and adaptive CT was performed in 30 patients (63.8%).

Results: With a median follow-up of 27.7 months (range, 5.9 to 75.8 months), the 2-year locoregional progression-free survival (LRPFS) and overall survival (OS) rates were 74.2% and 56.5%, respectively. The mean diagnostic and adaptive gross tumor volumes were 117.9 mL (range, 5.9 to 447 mL) and 36.8 mL (range, 0.3 to 230.6 mL), respectively. The median ETVRR was 71.4% (range, 30 to 97.6%) and the ETVRR >45% group showed significantly better OS (p < 0.0001) and LRPFS (p = 0.009) than the other group.

Conclusion: ETVRR as a parameter for early treatment response may be a useful prognostic factor to predict treatment outcome in LS-SCLC patients treated with CRT.

No MeSH data available.


Related in: MedlinePlus