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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

Results based on early treatment volume reduction rate (ETVRR): (A) overall survival and (B) locoregional progression-free survival.
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Figure 2: Results based on early treatment volume reduction rate (ETVRR): (A) overall survival and (B) locoregional progression-free survival.

Mentions: ETVRR was a statistically effective prognostic factor for OS (p = 0.012) and PFS (p = 0.015). In the univariate analysis with median cutoff value, initial GTV, OVRR, ECVRR, and ETVRR showed no prognostic impact on survival outcome (all p > 0.05). To reveal most effective cutoff value of VRR, we assessed every 5% interval around median. By this process, we concluded that ETVRR with 45% cutoff value correlated significantly with OS (p < 0.0001) and LRPFS (p = 0.009) (Table 3). The median OS and LRPFS were 31.3 and 47.5 months for patients with greater than 45% ETVRR, respectively, compared with 8.3 and 6.3 months for those with a lower than 45% value (Fig. 2). Nodal status was a statistically significant prognostic factor of DMFS when comparing the N3 group versus N0-2 group (p = 0.049). Other factors of age, sex, ECOG PS, stage except for nodal status, RT dose, SER, PCI did not show statistically significant difference with regard to survival outcomes.


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)

Results based on early treatment volume reduction rate (ETVRR): (A) overall survival and (B) locoregional progression-free survival.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Results based on early treatment volume reduction rate (ETVRR): (A) overall survival and (B) locoregional progression-free survival.
Mentions: ETVRR was a statistically effective prognostic factor for OS (p = 0.012) and PFS (p = 0.015). In the univariate analysis with median cutoff value, initial GTV, OVRR, ECVRR, and ETVRR showed no prognostic impact on survival outcome (all p > 0.05). To reveal most effective cutoff value of VRR, we assessed every 5% interval around median. By this process, we concluded that ETVRR with 45% cutoff value correlated significantly with OS (p < 0.0001) and LRPFS (p = 0.009) (Table 3). The median OS and LRPFS were 31.3 and 47.5 months for patients with greater than 45% ETVRR, respectively, compared with 8.3 and 6.3 months for those with a lower than 45% value (Fig. 2). Nodal status was a statistically significant prognostic factor of DMFS when comparing the N3 group versus N0-2 group (p = 0.049). Other factors of age, sex, ECOG PS, stage except for nodal status, RT dose, SER, PCI did not show statistically significant difference with regard to survival outcomes.

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