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Predicting per-lesion local recurrence in locally advanced non-small cell lung cancer following definitive radiation therapy using pre- and mid-treatment metabolic tumor volume.
Binkley, Michael S; Koenig, Julie L; Kashyap, Mehr; Xiang, Michael; Liu, Yufei; Sodji, Quaovi; Maxim, Peter G; Diehn, Maximilian; Loo, Billy W; Gensheimer, Michael F.
Afiliación
  • Binkley MS; Department of Radiation Oncology, Stanford University School of Medicine and Stanford Cancer Institute, 875 Blake Wilbur Dr MC 5847, Stanford, CA, 94305, USA.
  • Koenig JL; Department of Radiation Oncology, Stanford University School of Medicine and Stanford Cancer Institute, 875 Blake Wilbur Dr MC 5847, Stanford, CA, 94305, USA.
  • Kashyap M; Department of Radiation Oncology, Stanford University School of Medicine and Stanford Cancer Institute, 875 Blake Wilbur Dr MC 5847, Stanford, CA, 94305, USA.
  • Xiang M; Department of Radiation Oncology, Stanford University School of Medicine and Stanford Cancer Institute, 875 Blake Wilbur Dr MC 5847, Stanford, CA, 94305, USA.
  • Liu Y; Department of Radiation Oncology, Stanford University School of Medicine and Stanford Cancer Institute, 875 Blake Wilbur Dr MC 5847, Stanford, CA, 94305, USA.
  • Sodji Q; Department of Radiation Oncology, Stanford University School of Medicine and Stanford Cancer Institute, 875 Blake Wilbur Dr MC 5847, Stanford, CA, 94305, USA.
  • Maxim PG; Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN, USA.
  • Diehn M; Department of Radiation Oncology, Stanford University School of Medicine and Stanford Cancer Institute, 875 Blake Wilbur Dr MC 5847, Stanford, CA, 94305, USA. diehn@stanford.edu.
  • Loo BW; Institute for Stem Cell Biology & Regenerative Medicine, Stanford University School of Medicine, Stanford, California, USA. diehn@stanford.edu.
  • Gensheimer MF; Department of Radiation Oncology, Stanford University School of Medicine and Stanford Cancer Institute, 875 Blake Wilbur Dr MC 5847, Stanford, CA, 94305, USA. bwloo@stanford.edu.
Radiat Oncol ; 15(1): 114, 2020 May 19.
Article en En | MEDLINE | ID: mdl-32429982
BACKGROUND: We evaluated whether pre- and mid-treatment metabolic tumor volume (MTV) predicts per lesion local recurrence (LR) in patients treated with definitive radiation therapy (RT, dose≥60 Gy) for locally advanced non-small cell lung cancer (NSCLC). METHODS: We retrospectively reviewed records of patients with stage III NSCLC treated from 2006 to 2018 with pre- and mid-RT PET-CT. We measured the MTV of treated lesions on the pre-RT (MTVpre) and mid-RT (MTVmid) PET-CT. LR was defined per lesion as recurrence within the planning target volume. Receiver operating characteristic (ROC) curves, cumulative incidence rates, and uni- and multivariable (MVA) competing risk regressions were used to evaluate the association between MTV and LR. RESULTS: We identified 111 patients with 387 lesions (112 lung tumors and 275 lymph nodes). Median age was 68 years, 69.4% were male, 46.8% had adenocarcinoma, 39.6% had squamous cell carcinoma, and 95.5% received concurrent chemotherapy. Median follow-up was 38.7 months. 3-year overall survival was 42.3%. 3-year cumulative incidence of LR was 26.8% per patient and 11.9% per lesion. Both MTVpre and MTVmid were predictive of LR by ROC (AUC = 0.71 and 0.76, respectively) and were significantly associated with LR on MVA (P = 0.004 and P = 7.1e-5, respectively). Among lesions at lower risk of LR based on MTVpre, higher MTVmid was associated with LR (P = 0.001). CONCLUSION: Per-lesion, larger MTVpre and MTVmid predicted for increased risk of LR. MTVmid was more highly predictive of LR than MTVpre and if validated may allow for further discrimination of high-risk lesions at mid-RT informing dose painting strategies.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma de Pulmón de Células no Pequeñas / Neoplasias Pulmonares / Recurrencia Local de Neoplasia Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Radiat Oncol Asunto de la revista: NEOPLASIAS / RADIOTERAPIA Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma de Pulmón de Células no Pequeñas / Neoplasias Pulmonares / Recurrencia Local de Neoplasia Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Radiat Oncol Asunto de la revista: NEOPLASIAS / RADIOTERAPIA Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido