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

Radiation Oncology Journal
2015년 33권 2호 p.117 ~ p.125
이주환 ( Lee Joo-hwan ) - Yonsei University College of Medicine Department of Radiation Oncology

이정심 ( Lee Jeong-Shim ) - Yonsei University College of Medicine Yonsei Cancer Center Department of Radiation Oncology
최진현 ( Choi Jin-Hyun ) - Yonsei University College of Medicine Severance Hospital Department of Radiation Oncology
김준원 ( Kim Jun-Won ) - Yonsei University College of Medicine Gangnam Severance Hospital Department of Radiation Oncology
조재호 ( Cho Jae-Ho ) - Yonsei University College of Medicine Department of Radiation Oncology
이창걸 ( Lee Chang-Geol ) - Yonsei University College of Medicine Yonsei Cancer Hospital Departments of Radiation Oncology

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.

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