Early radiologic and metabolic tumour response assessment during combined chemo-radiotherapy for locally advanced NSCLC

Background - The role of early treatment response for patients with locally advanced non-small cell lung cancer (LA-NSCLC) treated with concurrent chemo-radiotherapy (cCRT) is unclear. The study aims to investigate the predictive value of response to induction chemotherapy (iCX) and the correlation...

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Hauptverfasser: Tvilum, Marie (VerfasserIn) , Knap, Marianne Marquard (VerfasserIn) , Hoffmann, Lone (VerfasserIn) , Khalil, Azza Ahmed (VerfasserIn) , Appelt, Ane L. (VerfasserIn) , Haraldsen, Ate (VerfasserIn) , Alber, Markus (VerfasserIn) , Grau, Cai (VerfasserIn) , Schmidt, Hjørdis Hjalting (VerfasserIn) , Kandi, Maria (VerfasserIn) , Holt, Marianne Ingerslev (VerfasserIn) , Lutz, Christina Maria (VerfasserIn) , Møller, Ditte Sloth (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: March 2024
In: Clinical and translational radiation oncology
Year: 2024, Jahrgang: 45, Pages: 1-8
ISSN:2405-6308
DOI:10.1016/j.ctro.2024.100737
Online-Zugang:Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.ctro.2024.100737
Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S2405630824000144
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Verfasserangaben:Marie Tvilum, Marianne Marquard Knap, Lone Hoffmann, Azza Ahmed Khalil, Ane L. Appelt, Ate Haraldsen, Markus Alber, Cai Grau, Hjørdis Hjalting Schmidt, Maria Kandi, Marianne Ingerslev Holt, Christina Maria Lutz, Ditte Sloth Møller

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245 1 0 |a Early radiologic and metabolic tumour response assessment during combined chemo-radiotherapy for locally advanced NSCLC  |c Marie Tvilum, Marianne Marquard Knap, Lone Hoffmann, Azza Ahmed Khalil, Ane L. Appelt, Ate Haraldsen, Markus Alber, Cai Grau, Hjørdis Hjalting Schmidt, Maria Kandi, Marianne Ingerslev Holt, Christina Maria Lutz, Ditte Sloth Møller 
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520 |a Background - The role of early treatment response for patients with locally advanced non-small cell lung cancer (LA-NSCLC) treated with concurrent chemo-radiotherapy (cCRT) is unclear. The study aims to investigate the predictive value of response to induction chemotherapy (iCX) and the correlation with pattern of failure (PoF). - Materials and methods - Patients with LA-NSCLC treated with cCRT were included for analyses (n = 276). Target delineations were registered from radiotherapy planning PET/CT to diagnostic PET/CT, in between which patients received iCX. Volume, sphericity, and SUVpeak were extracted from each scan. First site of failure was categorised as loco-regional (LR), distant (DM), or simultaneous LR+M (LR+M). Fine and Gray models for PoF were performed: a baseline model (including performance status (PS), stage, and histology), an image model for squamous cell carcinoma (SCC), and an image model for non-SCC. Parameters included PS, volume (VOL) of tumour, VOL of lymph nodes, ΔVOL, sphericity, SUVpeak, ΔSUVpeak, and oligometastatic disease. - Results - Median follow-up was 7.6 years. SCC had higher sub-distribution hazard ratio (sHR) for LRF (sHR = 2.771 [1.577:4.87], p < 0.01) and decreased sHR for DM (sHR = 0.247 [0.125:0.485], p < 0.01). For both image models, high diagnostic SUVpeak increased risk of LRF (sHR = 1.059 [1.05:1.106], p < 0.01 for SCC, sHR = 1.12 [1.03:1.21], p < 0.01 for non-SCC). Patients with SCC and less decrease in VOL had higher sHR for DM (sHR = 1.025[1.001:1.048] pr. % increase, p = 0.038). - Conclusion - Poor response in disease volume was correlated with higher sHR of DM for SCC, no other clear correlation of response and PoF was observed. Histology significantly correlated with PoF with SCC prone to LRF and non-SCC prone to DM as first site of failure. High SUVpeak at diagnosis increased the risk of LRF for both histologies. 
650 4 |a Early treatment response 
650 4 |a Non-small cell lung cancer 
650 4 |a Pattern of failure 
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700 1 |a Hoffmann, Lone  |e VerfasserIn  |4 aut 
700 1 |a Khalil, Azza Ahmed  |e VerfasserIn  |4 aut 
700 1 |a Appelt, Ane L.  |e VerfasserIn  |4 aut 
700 1 |a Haraldsen, Ate  |e VerfasserIn  |4 aut 
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700 1 |a Kandi, Maria  |e VerfasserIn  |4 aut 
700 1 |a Holt, Marianne Ingerslev  |e VerfasserIn  |4 aut 
700 1 |a Lutz, Christina Maria  |e VerfasserIn  |4 aut 
700 1 |a Møller, Ditte Sloth  |e VerfasserIn  |4 aut 
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