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Reduction in Tumor Volume by Cone Beam Computed Tomography Predicts Overall Survival in Non-Small Cell Lung Cancer Treated With Chemoradiation Therapy.

Publication ,  Conference
Jabbour, SK; Kim, S; Haider, SA; Xu, X; Wu, A; Surakanti, S; Aisner, J; Langenfeld, J; Yue, NJ; Haffty, BG; Zou, W
Published in: International journal of radiation oncology, biology, physics
July 2015

We sought to evaluate whether tumor response using cone beam computed tomography (CBCT) performed as part of the routine care during chemoradiation therapy (CRT) could forecast the outcome of unresectable, locally advanced, non-small cell lung cancer (NSCLC).We manually delineated primary tumor volumes (TV) of patients with NSCLC who were treated with radical CRT on days 1, 8, 15, 22, 29, 36, and 43 on CBCTs obtained as part of the standard radiation treatment course. Percentage reductions in TV were calculated and then correlated to survival and pattern of recurrence using Cox proportional hazard models. Clinical information including histologic subtype was also considered in the study of such associations.We evaluated 38 patients with a median follow-up time of 23.4 months. The median TV reduction was 39.3% (range, 7.3%-69.3%) from day 1 (D1) to day 43 (D43) CBCTs. Overall survival was associated with TV reduction from D1 to D43 (hazard ratio [HR] 0.557, 95% CI 0.39-0.79, P=.0009). For every 10% decrease in TV from D1 to D43, the risk of death decreased by 44.3%. For patients whose TV decreased ≥39.3 or <39.3%, log-rank test demonstrated a separation in survival (P=.02), with median survivals of 31 months versus 10 months, respectively. Neither local recurrence (HR 0.791, 95% CI 0.51-1.23, P=.29), nor distant recurrence (HR 0.78, 95% CI 0.57-1.08, P=.137) correlated with TV decrease from D1 to D43. Histologic subtype showed no impact on our findings.TV reduction as determined by CBCT during CRT as part of routine care predicts post-CRT survival. Such knowledge may justify intensification of RT or application of additional therapies. Assessment of genomic characteristics of these tumors may permit a better understanding of behavior or prediction of therapeutic outcomes.

Duke Scholars

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Published In

International journal of radiation oncology, biology, physics

DOI

EISSN

1879-355X

ISSN

0360-3016

Publication Date

July 2015

Volume

92

Issue

3

Start / End Page

627 / 633

Related Subject Headings

  • Tumor Burden
  • Radiotherapy, Image-Guided
  • Radiotherapy Dosage
  • Proportional Hazards Models
  • Oncology & Carcinogenesis
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Male
  • Lung Neoplasms
  • Humans
 

Citation

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Jabbour, S. K., Kim, S., Haider, S. A., Xu, X., Wu, A., Surakanti, S., … Zou, W. (2015). Reduction in Tumor Volume by Cone Beam Computed Tomography Predicts Overall Survival in Non-Small Cell Lung Cancer Treated With Chemoradiation Therapy. In International journal of radiation oncology, biology, physics (Vol. 92, pp. 627–633). https://doi.org/10.1016/j.ijrobp.2015.02.017
Jabbour, Salma K., Sinae Kim, Syed A. Haider, Xiaoting Xu, Alson Wu, Sujani Surakanti, Joseph Aisner, et al. “Reduction in Tumor Volume by Cone Beam Computed Tomography Predicts Overall Survival in Non-Small Cell Lung Cancer Treated With Chemoradiation Therapy.” In International Journal of Radiation Oncology, Biology, Physics, 92:627–33, 2015. https://doi.org/10.1016/j.ijrobp.2015.02.017.
Jabbour SK, Kim S, Haider SA, Xu X, Wu A, Surakanti S, et al. Reduction in Tumor Volume by Cone Beam Computed Tomography Predicts Overall Survival in Non-Small Cell Lung Cancer Treated With Chemoradiation Therapy. In: International journal of radiation oncology, biology, physics. 2015. p. 627–33.
Jabbour, Salma K., et al. “Reduction in Tumor Volume by Cone Beam Computed Tomography Predicts Overall Survival in Non-Small Cell Lung Cancer Treated With Chemoradiation Therapy.International Journal of Radiation Oncology, Biology, Physics, vol. 92, no. 3, 2015, pp. 627–33. Epmc, doi:10.1016/j.ijrobp.2015.02.017.
Jabbour SK, Kim S, Haider SA, Xu X, Wu A, Surakanti S, Aisner J, Langenfeld J, Yue NJ, Haffty BG, Zou W. Reduction in Tumor Volume by Cone Beam Computed Tomography Predicts Overall Survival in Non-Small Cell Lung Cancer Treated With Chemoradiation Therapy. International journal of radiation oncology, biology, physics. 2015. p. 627–633.
Journal cover image

Published In

International journal of radiation oncology, biology, physics

DOI

EISSN

1879-355X

ISSN

0360-3016

Publication Date

July 2015

Volume

92

Issue

3

Start / End Page

627 / 633

Related Subject Headings

  • Tumor Burden
  • Radiotherapy, Image-Guided
  • Radiotherapy Dosage
  • Proportional Hazards Models
  • Oncology & Carcinogenesis
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Male
  • Lung Neoplasms
  • Humans