Reduction in Tumor Volume by Cone Beam Computed Tomography Predicts Overall Survival in Non-Small Cell Lung Cancer Treated With Chemoradiation Therapy
Reduction in Tumor Volume by Cone Beam Computed Tomography Predicts Overall Survival in Non-Small Cell Lung Cancer Treated With Chemoradiation Therapy
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DOI：
10.1016/j.ijrobp.2015.02.017
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发表时间：
2015-07-01
影响因子：
7
通讯作者：
Zou, Wei
中科院分区：
文献类型：
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作者：
Jabbour, Salma K.;Kim, Sinae;Zou, Wei
目的：我们试图评估在放化疗（CRT）期间使用锥形束计算机断层扫描（CBCT）作为常规护理的一部分进行的肿瘤反应是否可以预测不可切除的局部晚期非小细胞肺癌（NSCLC）的结果。方法和材料：我们手动描绘了在第1、8、15、22、29、36天接受根治性CRT治疗的NSCLC患者的原发肿瘤体积（TV），43例接受标准放射治疗过程中的CBCT检查。计算TV降低百分比，然后使用考克斯比例风险模型将其与生存率和复发模式相关联。包括组织学亚型的临床信息也被认为是在这样的association.Results研究：我们评估了38例患者的平均随访时间为23.4个月。从第1天（D1）至第43天（D43）CBCT的中位TV降低为39.3%（范围，7.3%-69.3%）。总生存期与从D1至D43的TV降低相关（风险比[HR] 0.557，95%CI 0.39-0.79，P=.0009）。从D1到D43，TV每降低10%，死亡风险降低44.3%。对于TV降低>= 39.3或
Purpose: 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).Methods and Materials: 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.Results: 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