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Journal of Cancer Research and Clinical Oncology

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01-06-2018 | Original Article – Clinical Oncology

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

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

Published in: Journal of Cancer Research and Clinical Oncology | Issue 6/2018

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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Title: Is tumor volume reduction during radiotherapy prognostic relevant in patients with stage III non-small cell lung cancer?
Authors: Khaled Elsayad
Laith Samhouri
Sergiu Scobioala
Uwe Haverkamp
Hans Theodor Eich
Publication date: 01-06-2018
Publisher: Springer Berlin Heidelberg
Published in: Journal of Cancer Research and Clinical Oncology / Issue 6/2018
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI: https://doi.org/10.1007/s00432-018-2640-6

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Abstract

Purpose/objective(s)

Materials/methods

Results

Conclusion

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