Predictive and prognostic value of tumor volume and its changes during radical radiotherapy of stage III non-small cell lung cancer
PurposeLung cancer remains the leading cause of cancer-related mortality worldwide. Stage III non-small cell lung cancer (NSCLC) includes heterogeneous presentation of the disease including lymph node involvement and large tumour volumes with infiltration of the mediastinum, heart or spine. In the t...
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| Main Authors: | , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2018
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| In: |
Strahlentherapie und Onkologie
Year: 2017, Volume: 194, Issue: 2, Pages: 79-90 |
| ISSN: | 1439-099X |
| DOI: | 10.1007/s00066-017-1221-y |
| Online Access: | Verlag, Volltext: http://dx.doi.org/10.1007/s00066-017-1221-y Verlag, Volltext: https://link.springer.com/article/10.1007/s00066-017-1221-y 
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| Author Notes: | Lukas Käsmann, Maximilian Niyazi, Oliver Blanck, Christian Baues, René Baumann, Sophie Dobiasch, Chukwuka Eze, Daniel Fleischmann, Tobias Gauer, Frank A. Giordano, Yvonne Goy, Jan Hausmann, Christoph Henkenberens, David Kaul, Lisa Klook, David Krug, Matthias Mäurer, Cédric M. Panje, Johannes Rosenbrock, Lisa Sautter, Daniela Schmitt, Christoph Süß, Alexander H. Thieme, Maike Trommer-Nestler, Sonia Ziegler, Nadja Ebert, Daniel Medenwald, Christian Ostheimer, Young DEGRO Trial Group |
| Summary: | PurposeLung cancer remains the leading cause of cancer-related mortality worldwide. Stage III non-small cell lung cancer (NSCLC) includes heterogeneous presentation of the disease including lymph node involvement and large tumour volumes with infiltration of the mediastinum, heart or spine. In the treatment of stage III NSCLC an interdisciplinary approach including radiotherapy is considered standard of care with acceptable toxicity and improved clinical outcome concerning local control. Furthermore, gross tumour volume (GTV) changes during definitive radiotherapy would allow for adaptive replanning which offers normal tissue sparing and dose escalation.MethodsA literature review was conducted to describe the predictive value of GTV changes during definitive radiotherapy especially focussing on overall survival. The literature search was conducted in a two-step review process using PubMed®/Medline® with the key words “stage III non-small cell lung cancer” and “radiotherapy” and “tumour volume” and “prognostic factors”.ResultsAfter final consideration 17, 14 and 9 studies with a total of 2516, 784 and 639 patients on predictive impact of GTV, GTV changes and its impact on overall survival, respectively, for definitive radiotherapy for stage III NSCLC were included in this review. Initial GTV is an important prognostic factor for overall survival in several studies, but the time of evaluation and the value of histology need to be further investigated. GTV changes during RT differ widely, optimal timing for re-evaluation of GTV and their predictive value for prognosis needs to be clarified. The prognostic value of GTV changes is unclear due to varying study qualities, re-evaluation time and conflicting results.ConclusionThe main findings were that the clinical impact of GTV changes during definitive radiotherapy is still unclear due to heterogeneous study designs with varying quality. Several potential confounding variables were found and need to be considered for future studies to evaluate GTV changes during definitive radiotherapy with respect to treatment outcome. |
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| Item Description: | Published online: 13 October 2017 Gesehen am 02.07.2018 |
| Physical Description: | Online Resource |
| ISSN: | 1439-099X |
| DOI: | 10.1007/s00066-017-1221-y |