The prognostic value of volumetric changes of the primary tumor measured on Cone Beam-CT during radiotherapy for concurrent chemoradiation in NSCLC patients

Margriet Kwint; Barbara Stam; Cécile Proust-Lima; Viviane Philipps; Trynke Hoekstra; Else Aalbersberg; Maddalena Rossi; Jan Jakob Sonke; José Belderbos; Iris Walraven

doi:10.1016/j.radonc.2020.02.002

The prognostic value of volumetric changes of the primary tumor measured on Cone Beam-CT during radiotherapy for concurrent chemoradiation in NSCLC patients

Margriet Kwint, Barbara Stam, Cécile Proust-Lima, Viviane Philipps, Trynke Hoekstra, Else Aalbersberg, Maddalena Rossi, Jan Jakob Sonke, José Belderbos, Iris Walraven^*

^*Corresponding author for this work

Research output: Contribution to Journal › Article › Academic › peer-review

86 Downloads (Pure)

Abstract

INTRODUCTION: The aim of this study was to identify subgroups of locally advanced NSCLC patients with a distinct treatment response during concurrent chemoradiotherapy (CCRT). Subsequently, we investigated the association of subgroup membership with treatment outcomes.

METHODS: 394 NSCLC-patients treated with CCRT between 2007 and 2013 were included. Gross Tumor Volume (GTV) during treatment was determined and relative GTV-volume change from the planning-CT was subsequently calculated. Latent Class Mixed Modeling (LCMM) was used to identify subgroups with distinct volume changes during CCRT. The association of subgroup membership with overall survival (OS), progression free survival (PFS) and local regional control (LRC) was assessed using cox regression analyses.

RESULTS: Three subgroups of GTV-volume change during treatment were identified, with each subsequent subgroup showing a more profound reduction of GTV during treatment. No associations between subgroup membership and OS, PFS nor LRC were observed. Nonetheless, baseline GTV (HR1.42; 95%CI 1.06-1.91) was significantly associated with OS.

CONCLUSIONS: Three different subgroups of GTV-volume change during treatment were identified. Surprisingly, these subgroups did not differ in their risk of treatment outcomes. Only patients with a larger GTV at baseline had a significantly worse OS. Therefore, risk stratification at baseline might already be accurate in identifying the best treatment strategy for most patients.

Original language	English
Pages (from-to)	44-51
Number of pages	8
Journal	Radiotherapy and Oncology
Volume	146
Early online date	27 Feb 2020
DOIs	https://doi.org/10.1016/j.radonc.2020.02.002
Publication status	Published - May 2020

Bibliographical note

Funding

The department of radiation oncology of the Netherlands Cancer Institute receives license fees from Elekta Oncology Systems Ltd. This research was partially funded by a Top sector Life Sciences & Health (LSH-TKI Foundation) public–private partnership grant (LSHM15036) in collaboration with Elekta Oncology Systems Ltd. This work was sponsored in part by a research grant from Elekta Oncology Systems Ltd .

Funders	Funder number
Elekta Oncology Systems Ltd
LSH-TKI Foundation	LSHM15036

Keywords

Concurrent chemoradiation
Cone-Beam-CT
Latent Class Mixed Modelling
Locally Advanced NSCLC
Volumetric changes

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.radonc.2020.02.002

The prognostic value of volumetric changes of the primary tumor measured on Cone Beam-CT during radiotherapy for concurrent chemoradiation in NSCLC patientsFinal published version, 1.04 MBLicence: Article 25fa Dutch Copyright Act

Persistent URL (handle)

Persistent link

Cite this

Kwint, M., Stam, B., Proust-Lima, C., Philipps, V., Hoekstra, T., Aalbersberg, E., Rossi, M., Sonke, J. J., Belderbos, J., & Walraven, I. (2020). The prognostic value of volumetric changes of the primary tumor measured on Cone Beam-CT during radiotherapy for concurrent chemoradiation in NSCLC patients. Radiotherapy and Oncology, 146, 44-51. https://doi.org/10.1016/j.radonc.2020.02.002

@article{f92a820100cb4f46afc14af2c8b9e68a,

title = "The prognostic value of volumetric changes of the primary tumor measured on Cone Beam-CT during radiotherapy for concurrent chemoradiation in NSCLC patients",

abstract = "INTRODUCTION: The aim of this study was to identify subgroups of locally advanced NSCLC patients with a distinct treatment response during concurrent chemoradiotherapy (CCRT). Subsequently, we investigated the association of subgroup membership with treatment outcomes.METHODS: 394 NSCLC-patients treated with CCRT between 2007 and 2013 were included. Gross Tumor Volume (GTV) during treatment was determined and relative GTV-volume change from the planning-CT was subsequently calculated. Latent Class Mixed Modeling (LCMM) was used to identify subgroups with distinct volume changes during CCRT. The association of subgroup membership with overall survival (OS), progression free survival (PFS) and local regional control (LRC) was assessed using cox regression analyses.RESULTS: Three subgroups of GTV-volume change during treatment were identified, with each subsequent subgroup showing a more profound reduction of GTV during treatment. No associations between subgroup membership and OS, PFS nor LRC were observed. Nonetheless, baseline GTV (HR1.42; 95%CI 1.06-1.91) was significantly associated with OS.CONCLUSIONS: Three different subgroups of GTV-volume change during treatment were identified. Surprisingly, these subgroups did not differ in their risk of treatment outcomes. Only patients with a larger GTV at baseline had a significantly worse OS. Therefore, risk stratification at baseline might already be accurate in identifying the best treatment strategy for most patients.",

keywords = "Concurrent chemoradiation, Cone-Beam-CT, Latent Class Mixed Modelling, Locally Advanced NSCLC, Volumetric changes",

author = "Margriet Kwint and Barbara Stam and C{\'e}cile Proust-Lima and Viviane Philipps and Trynke Hoekstra and Else Aalbersberg and Maddalena Rossi and Sonke, {Jan Jakob} and Jos{\'e} Belderbos and Iris Walraven",

year = "2020",

month = may,

doi = "10.1016/j.radonc.2020.02.002",

language = "English",

volume = "146",

pages = "44--51",

journal = "Radiotherapy and Oncology",

issn = "0167-8140",

publisher = "Elsevier Ireland Ltd",

}

Kwint, M, Stam, B, Proust-Lima, C, Philipps, V, Hoekstra, T, Aalbersberg, E, Rossi, M, Sonke, JJ, Belderbos, J & Walraven, I 2020, 'The prognostic value of volumetric changes of the primary tumor measured on Cone Beam-CT during radiotherapy for concurrent chemoradiation in NSCLC patients', Radiotherapy and Oncology, vol. 146, pp. 44-51. https://doi.org/10.1016/j.radonc.2020.02.002

TY - JOUR

T1 - The prognostic value of volumetric changes of the primary tumor measured on Cone Beam-CT during radiotherapy for concurrent chemoradiation in NSCLC patients

AU - Kwint, Margriet

AU - Stam, Barbara

AU - Proust-Lima, Cécile

AU - Philipps, Viviane

AU - Hoekstra, Trynke

AU - Aalbersberg, Else

AU - Rossi, Maddalena

AU - Sonke, Jan Jakob

AU - Belderbos, José

AU - Walraven, Iris

PY - 2020/5

Y1 - 2020/5

N2 - INTRODUCTION: The aim of this study was to identify subgroups of locally advanced NSCLC patients with a distinct treatment response during concurrent chemoradiotherapy (CCRT). Subsequently, we investigated the association of subgroup membership with treatment outcomes.METHODS: 394 NSCLC-patients treated with CCRT between 2007 and 2013 were included. Gross Tumor Volume (GTV) during treatment was determined and relative GTV-volume change from the planning-CT was subsequently calculated. Latent Class Mixed Modeling (LCMM) was used to identify subgroups with distinct volume changes during CCRT. The association of subgroup membership with overall survival (OS), progression free survival (PFS) and local regional control (LRC) was assessed using cox regression analyses.RESULTS: Three subgroups of GTV-volume change during treatment were identified, with each subsequent subgroup showing a more profound reduction of GTV during treatment. No associations between subgroup membership and OS, PFS nor LRC were observed. Nonetheless, baseline GTV (HR1.42; 95%CI 1.06-1.91) was significantly associated with OS.CONCLUSIONS: Three different subgroups of GTV-volume change during treatment were identified. Surprisingly, these subgroups did not differ in their risk of treatment outcomes. Only patients with a larger GTV at baseline had a significantly worse OS. Therefore, risk stratification at baseline might already be accurate in identifying the best treatment strategy for most patients.

AB - INTRODUCTION: The aim of this study was to identify subgroups of locally advanced NSCLC patients with a distinct treatment response during concurrent chemoradiotherapy (CCRT). Subsequently, we investigated the association of subgroup membership with treatment outcomes.METHODS: 394 NSCLC-patients treated with CCRT between 2007 and 2013 were included. Gross Tumor Volume (GTV) during treatment was determined and relative GTV-volume change from the planning-CT was subsequently calculated. Latent Class Mixed Modeling (LCMM) was used to identify subgroups with distinct volume changes during CCRT. The association of subgroup membership with overall survival (OS), progression free survival (PFS) and local regional control (LRC) was assessed using cox regression analyses.RESULTS: Three subgroups of GTV-volume change during treatment were identified, with each subsequent subgroup showing a more profound reduction of GTV during treatment. No associations between subgroup membership and OS, PFS nor LRC were observed. Nonetheless, baseline GTV (HR1.42; 95%CI 1.06-1.91) was significantly associated with OS.CONCLUSIONS: Three different subgroups of GTV-volume change during treatment were identified. Surprisingly, these subgroups did not differ in their risk of treatment outcomes. Only patients with a larger GTV at baseline had a significantly worse OS. Therefore, risk stratification at baseline might already be accurate in identifying the best treatment strategy for most patients.

KW - Concurrent chemoradiation

KW - Cone-Beam-CT

KW - Latent Class Mixed Modelling

KW - Locally Advanced NSCLC

KW - Volumetric changes

UR - http://www.scopus.com/inward/record.url?scp=85080034188&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85080034188&partnerID=8YFLogxK

U2 - 10.1016/j.radonc.2020.02.002

DO - 10.1016/j.radonc.2020.02.002

M3 - Article

C2 - 32114265

SN - 0167-8140

VL - 146

SP - 44

EP - 51

JO - Radiotherapy and Oncology

JF - Radiotherapy and Oncology

ER -

The prognostic value of volumetric changes of the primary tumor measured on Cone Beam-CT during radiotherapy for concurrent chemoradiation in NSCLC patients

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

Access to Document

Persistent URL (handle)

Other files and links

Fingerprint

Cite this