The effect of tumor volume and its change on survival in stage III non-small cell lung cancer treated with definitive concurrent chemoradiotherapy

Tae Ryool Koo, Sung Ho Moon, Yu Jin Lim, Ja Young Kim, Yeonjoo Kim, Tae Hyun Kim, Kwan Ho Cho, Ji-Youn Han, Young Joo Lee, Tak Yun, Heung Tae Kim, Jin Soo Lee
Radiation Oncology 2014, 9: 283

BACKGROUND: To investigate a prognostic role of gross tumor volume (GTV) changes on survival outcomes following concurrent chemoradiotherapy (CCRT) in stage III non-small-cell lung cancer (NSCLC) patients.

METHODS: We enrolled 191 patients with stage III NSCLC from 2001 to 2009 undergoing definitive CCRT. The GTV of 157 patients was delineated at the planning CT prior to CCRT and with a follow-up CT 1 month after CCRT. We assessed the volumetric parameters of pre-treatment GTV (GTVpre) post-treatment GTV (GTVpost), and volume reduction ratio of GTV (VRR). The primary endpoint was overall survival (OS) and secondary endpoints were progression-free survival (PFS) and locoregional progression-free survival (LRPFS). The best cut-off value was defined as that which exhibited the maximum difference between the two groups.

RESULTS: The median follow-up duration was 52.7 months in surviving patients. Median survival, 3-year OS, PFS and LRPFS rates were 25.5 months, 36.4%, 23.0%, and 45.0%, respectively. The selected cut-off values were 50 cm(3) for GTVpre, 20 cm(3) for GTVpost, and 50% for VRR. The smaller GTVpre and GTVpost values were associated with better OS (p<0.001 and p=0.015) and PFS (p=0.001 and p=0.004), respectively, upon univariate analysis. The higher VRR of > 50% was associated with a trend toward poorer OS (p=0.004) and PFS (p=0.054). Upon multivariate analysis, smaller GTVpre indicated significantly improved OS (p=0.001), PFS (p=0.013) and LRPFS (p=0.002), while smaller GTVpost was marginally significant for PFS (p=0.086). Higher VRR was associated with a trend toward poorer OS (p=0.075).

CONCLUSIONS: In patients with stage III NSCLC undergoing definitive CCRT, GTVpre was an independent prognostic factor of survival. Notably, improved outcome was not correlated with higher VRR after short-term follow-up with CT alone.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"