Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
권호 표지
DOI QR코드

DOI QR Code

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)
  • Received : 2015.05.06
  • Accepted : 2015.06.10
  • Published : 2015.06.30
Download PDF
⟨ Previous Next ⟩

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

References

  1. Adjei AA, Marks RS, Bonner JA. Current guidelines for the management of small cell lung cancer. Mayo Clin Proc 1999;74:809-16. https://doi.org/10.4065/74.8.809
  2. 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. https://doi.org/10.3322/caac.20121
  3. 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. https://doi.org/10.1200/JCO.1992.10.6.890
  4. 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. https://doi.org/10.1056/NEJM199212033272302
  5. van Meerbeeck JP, Fennell DA, De Ruysscher DK. Small-cell lung cancer. Lancet 2011;378:1741-55. https://doi.org/10.1016/S0140-6736(11)60165-7
  6. 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.
  7. 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. https://doi.org/10.1016/j.ijrobp.2008.08.052
  8. 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. https://doi.org/10.1016/j.ijrobp.2012.10.003
  9. 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. https://doi.org/10.1016/j.ijrobp.2004.11.005
  10. 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. https://doi.org/10.1016/j.ijrobp.2009.12.055
  11. 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.
  12. 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. https://doi.org/10.1016/S0169-5002(02)00072-7
  13. 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. https://doi.org/10.1002/cncr.25537
  14. 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. https://doi.org/10.1016/j.ejca.2008.10.026
  15. Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron 1976;16:31-41. https://doi.org/10.1159/000180580
  16. 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. https://doi.org/10.1002/1097-0142(19800601)45:11<2744::AID-CNCR2820451108>3.0.CO;2-U
  17. 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. https://doi.org/10.1093/jnci/83.6.417
  18. 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. https://doi.org/10.1093/jnci/84.1.58
  19. 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. https://doi.org/10.1016/S0360-3016(01)01772-2
  20. 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. https://doi.org/10.1016/j.ijrobp.2007.06.034
  21. 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. https://doi.org/10.1016/j.ijrobp.2005.07.967
  22. 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. https://doi.org/10.1186/s13014-014-0283-6
  23. 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. https://doi.org/10.3857/roj.2013.31.4.185

Cited by

  1. Stereotactic body radiation therapy for the treatment of a post-chemotherapy remnant lung mass in extensive-stage small-cell lung cancer: A case report vol.12, pp.2, 2015, https://doi.org/10.3892/etm.2016.3359
  2. 定量影像学在肺癌放/化疗疗效评估中的应用 vol.20, pp.6, 2015, https://doi.org/10.3779/j.issn.1009-3419.2017.06.07
  3. Study on the Dose Uncertainties in the Lung during Passive Proton Irradiation with a Proton Beam Range Compensator vol.72, pp.11, 2015, https://doi.org/10.3938/jkps.72.1369
  4. The Role of Dynamic Contrast-Enhanced Magnetic Resonance Imaging in Predicting Treatment Response for Cervical Cancer Treated with Concurrent Chemoradiotherapy vol.13, pp.None, 2015, https://doi.org/10.2147/cmar.s314289