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 JournalArticleAcademicpeer-review

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 languageEnglish
Pages (from-to)44-51
Number of pages8
JournalRadiotherapy and Oncology
Volume146
Early online date27 Feb 2020
DOIs
Publication statusPublished - May 2020

Bibliographical note

Copyright © 2020 Elsevier B.V. All rights reserved.

Keywords

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

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