Browse > Article
http://dx.doi.org/10.3857/roj.2015.33.2.117

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

Lee, Joohwan (Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine)
Lee, Jeongshim (Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine)
Choi, Jinhyun (Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine)
Kim, Jun Won (Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University College of Medicine)
Cho, Jaeho (Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine)
Lee, Chang Geol (Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine)
Publication Information
Radiation Oncology Journal / v.33, no.2, 2015 , pp. 117-125 More about this Journal
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.
Keywords
Small cell lung carcinoma; Radiotherapy; Tumor burden;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Dehing-Oberije C, Yu S, De Ruysscher D, et al. Development and external validation of prognostic model for 2-year survival of non-small-cell lung cancer patients treated with chemoradiotherapy. Int J Radiat Oncol Biol Phys 2009;74:355-62.   DOI
2 Le Chevalier T, Arriagada R, Tarayre M, et al. Significant effect of adjuvant chemotherapy on survival in locally advanced non-small-cell lung carcinoma. J Natl Cancer Inst 1992;84:58.   DOI
3 Yang SN, Liao CY, Chen SW, et al. Clinical implications of the tumor volume reduction rate in head-and-neck cancer during definitive intensity-modulated radiotherapy for organ preservation. Int J Radiat Oncol Biol Phys 2011;79:1096-103.   DOI
4 Bradley JD, Ieumwananonthachai N, Purdy JA, et al. Gross tumor volume, critical prognostic factor in patients treated with three-dimensional conformal radiation therapy for nonsmall- cell lung carcinoma. Int J Radiat Oncol Biol Phys 2002;52:49-57.   DOI
5 Perez CA, Stanley K, Rubin P, et al. A prospective randomized study of various irradiation doses and fractionation schedules in the treatment of inoperable non-oat-cell carcinoma of the lung: preliminary report by the Radiation Therapy Oncology Group. Cancer 1980;45:2744-53.   DOI
6 Sobin LH, Compton CC. TNM seventh edition: what's new, what's changed: communication from the International Union Against Cancer and the American Joint Committee on Cancer. Cancer 2010;116:5336-9.   DOI
7 Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 2009;45:228-47.   DOI
8 Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron 1976;16:31-41.   DOI
9 Le Chevalier T, Arriagada R, Quoix E, et al. Radiotherapy alone versus combined chemotherapy and radiotherapy in nonresectable non-small-cell lung cancer: first analysis of a randomized trial in 353 patients. J Natl Cancer Inst 1991;83:417-23.   DOI
10 Werner-Wasik M, Swann RS, Bradley J, et al. Increasing tumor volume is predictive of poor overall and progression-free survival: secondary analysis of the Radiation Therapy Oncology Group 93-11 phase I-II radiation dose-escalation study in patients with inoperable non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 2008;70:385-90.   DOI
11 Basaki K, Abe Y, Aoki M, Kondo H, Hatayama Y, Nakaji S. Prognostic factors for survival in stage III non-small-cell lung cancer treated with definitive radiation therapy: impact of tumor volume. Int J Radiat Oncol Biol Phys 2006;64:449-54.   DOI
12 Koo TR, Moon SH, Lim YJ, et al. The effect of tumor volume and its change on survival in stage III non-small cell lung cancer treated with definitive concurrent chemoradiotherapy. Radiat Oncol 2014;9:283.   DOI
13 Reymen B, Van Loon J, van Baardwijk et al. Total gross tumor volume is an independent prognostic factor in patients treated with selective nodal irradiation for stage I to III small cell lung cancer. Int J Radiat Oncol Biol Phys 2013;85:1319-24.   DOI
14 Ha IB, Jeong BK, Jeong H, et al. Effect of early chemoradiotherapy in patients with limited stage small cell lung cancer. Radiat Oncol J 2013;31:185-90.   DOI
15 Adjei AA, Marks RS, Bonner JA. Current guidelines for the management of small cell lung cancer. Mayo Clin Proc 1999;74:809-16.   DOI
16 Siegel R, Ward E, Brawley O, Jemal A. Cancer statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA Cancer J Clin 2011;61:212-36.   DOI
17 Warde P, Payne D. Does thoracic irradiation improve survival and local control in limited-stage small-cell carcinoma of the lung? A meta-analysis. J Clin Oncol 1992;10:890-5.   DOI
18 Pignon JP, Arriagada R, Ihde DC, et al. A meta-analysis of thoracic radiotherapy for small-cell lung cancer. N Engl J Med 1992;327:1618-24.   DOI
19 van Meerbeeck JP, Fennell DA, De Ruysscher DK. Small-cell lung cancer. Lancet 2011;378:1741-55.   DOI
20 International Commission on Radiation Units and Measurements. Prescribing, recording, and reporting photon beam therapy (Report 50). Bethesda, MD: International Commission on Radiation Units and Measurements; 1993.
21 Kim YH, Kim DY, Kim TH, et al. Usefulness of magnetic resonance volumetric evaluation in predicting response to preoperative concurrent chemoradiotherapy in patients with resectable rectal cancer. Int J Radiat Oncol Biol Phys 2005;62:761-8.   DOI
22 Werner-Wasik M, Xiao Y, Pequignot E, Curran WJ, Hauck W. Assessment of lung cancer response after nonoperative therapy: tumor diameter, bidimensional product, and volume: a serial CT scan-based study. Int J Radiat Oncol Biol Phys 2001;51:56-61.
23 Micke P, Faldum A, Metz T, et al. Staging small cell lung cancer: Veterans Administration Lung Study Group versus International Association for the Study of Lung Cancer: what limits limited disease? Lung Cancer 2002;37:271-6.   DOI