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Rao X, Liu H, Zhang Y, Xie Y, Wang G, Zhang S, Wu G, Wang Y, Zhou R. The relationship of body mass index to setup errors, dosimetric parameters and incidence of radiation pneumonitis in non-small cell lung cancer patients undergoing intensity-modulated radiation therapy: a single-center observational study. Int J Radiat Biol 2024; 100:248-255. [PMID: 37747796 DOI: 10.1080/09553002.2023.2261549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 09/14/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND The relationship among body mass index (BMI), setup error and radiation pneumonitis is not clearly illustrated. OBJECTIVE The present study aimed to investigate the role of BMI in non-small cell lung cancer (NSCLC) patients' radiation treatment, focusing on its relationship with setup error of patient positioning, the dosimetric parameters of intensity-modulated radiation therapy (IMRT) and the incidence of radiation pneumonitis. METHODS This prospective observational study included 523 cases of NSCLC patients during 2020-2022. Patients were divided into different groups by different BMI. The setup error was obtained by cone beam CT (CBCT) at three positions, lateral (LAT), longitudinal (LNG) and vertical (VRT). IMRT dosimetric parameters of V5, V20, and mean dose were collected. RESULTS Patients with BMI ≥28 kg/m2 showed significantly higher absolute values of LAT, LNG and VRT, higher V5, V20, mean dose, as well as higher total incidence of radiation pneumonitis and grade III radiation pneumonitis compared with patients with BMI <24 kg/m2 or 24-28 kg/m2. Spearman's analysis demonstrated that the absolute values of LAT, LNG and VRT were positively correlated with BMI, and positive correlation existed among BMI, dosimetric parameters and setup errors. ROC curves showed that LAT in setup errors and V5 in dosimetric parameters had the best diagnostic value for prediction of radiation pneumonitis. Only BMI, LAT, V5 and V20 were the independent risk factors for radiation pneumonitis. CONCLUSIONS Setup error caused by higher BMI might be associated with the dosimetric parameters, as well as the incidence of radiation pneumonitis in NSCLC patients.
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Affiliation(s)
- Xinrui Rao
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
- Institute of Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Hongyuan Liu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
- Institute of Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Yuewen Zhang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
- Institute of Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Yaqiong Xie
- Oncology Department, Jianli People's Hospital, Jingzhou, PR China
| | - Geng Wang
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Sheng Zhang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
- Institute of Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Gang Wu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
- Institute of Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Ye Wang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
- Institute of Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
| | - Rui Zhou
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
- Institute of Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China
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Price RG, Lloyd S, Wang X, Haaland B, Nelson G, Salter B. Adipose Tissue Distribution and Body Mass Index (BMI) Correlation With Daily Image-Guided Radiotherapy (IGRT) Shifts of Abdominal Radiation Therapy Patients. Cureus 2023; 15:e40979. [PMID: 37503478 PMCID: PMC10370477 DOI: 10.7759/cureus.40979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2023] [Indexed: 07/29/2023] Open
Abstract
Purpose There are several studies suggesting a correlation between image-guided radiotherapy (IGRT) setup errors and body mass index (BMI). However, abdominal fat content has visceral and subcutaneous components, which may affect setup errors differently. This study aims to analyze a potential workflow for characterizing adipose content and distribution in the region of the target that would allow a quickly calculated metric of abdominal fat content to stratify these patients. Methods IGRT shift data was retrospectively tabulated from daily fan-beam CT-on-rails pre-treatment alignment for 50 abdominal radiation therapy (RT) patients, and systematic and random errors in the daily setup were characterized by tabulating average and standard deviations of shift data for each patient and looking at differences for different distributions of adipose content. Visceral and subcutaneous fat content were defined by visceral fat area (VFA) and subcutaneous fat area (SFA) using a region-growing algorithm to contour adipose tissue on CT simulation scans. All contours were created for a single slice at the treatment isocenter, on which the VFA and SFA were calculated. A log-rank test was used to test trends in shifts over quartiles of adiposity. Results VFA ranged from 1.9-342.8c m2, and SFA from 11.8-756.0 cm2. The standard definition (SD) of random error (σ) in the lateral axis for Q1 vs. Q4 VFA was 0.10cm vs. 0.29cm, 0.12cm vs. 0.28cm for SFA, and 0.12cm vs. 0.31cm for BMI. The percentage of longitudinal shifts greater than 10mm for Q1 vs. Q4 VFA was 0% vs. 9%, 2% vs. 19% for SFA, and 0% vs. 20% for BMI. Statistically significant trends in shifts vs. the BMI quartile were seen for both pitch and the longitudinal direction, as well as for pitch corrections vs. the VFA quartile. Conclusion Within this dataset, abdominal cancer patients showed statistically significant trends in shift probability vs. BMI and VFA. Also, patients in the upper quartiles of all adiposity metrics showed an increased SD of σ in the lateral direction and increased shifts over 10 mm in the longitudinal direction. However, despite these relationships, neither VFA nor SFA offered discernible advantages in their relationship to shift uncertainty relative to BMI.
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Affiliation(s)
- Ryan G Price
- Radiation Oncology, University of Utah School of Medicine; Huntsman Cancer Institute, Salt Lake City, USA
| | - Shane Lloyd
- Radiation Oncology, University of Utah School of Medicine; Huntsman Cancer Institute, Salt Lake City, USA
| | - Xuechen Wang
- Biostatistics, University of Utah, Salt Lake City, USA
| | - Ben Haaland
- Biostatistics, University of Utah, Salt Lake City, USA
| | - Geoff Nelson
- Radiation Oncology, University of Utah School of Medicine; Huntsman Cancer Institute, Salt Lake City, USA
| | - Bill Salter
- Medical Physics, Radiation Oncology, University of Utah School of Medicine; Huntsman Cancer Institute, Salt Lake City, USA
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Shukla R, Gagan S, Padhi S, Patro K, Shukla S, Arora D, Singh T, Kundu C, Bhattacharya PS, Krishna V, Madhur P. Daily waiting time management for modern radiation oncology department in Indian perspective. J Cancer Res Ther 2022; 18:1796-1800. [DOI: 10.4103/jcrt.jcrt_1481_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kohl VKB, Weber K, Brunner M, Geppert CI, Fietkau R, Grützmann R, Semrau S, Merkel S. Factors influencing downstaging after neoadjuvant long-course chemoradiotherapy in rectal carcinoma. Int J Colorectal Dis 2022; 37:1355-1365. [PMID: 35545701 PMCID: PMC9167202 DOI: 10.1007/s00384-022-04174-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/23/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE This single-centre cohort study was designed to identify factors that can predict primary tumour downstaging by neoadjuvant chemoradiotherapy (nCRT) in rectal carcinoma. METHODS Prospectively collected data from 555 patients with clinical T category (cT) cT3-4 rectal carcinoma treated between 1995 and 2019 were retrospectively analysed. All patients received long-term neoadjuvant chemoradiotherapy followed by surgery with curative intent at the Department of Surgery, University Hospital Erlangen, Germany. Patient-, tumour- and treatment-related factors with a potential impact on the downstaging of rectal carcinoma to pathological T category (pT) ≤ ypT2 and ypT0 were analysed in univariate and multivariate logistic regression analyses. The prognosis of patients with and without downstaging of the primary tumour was compared. RESULTS A total of 288 (51.9%) patients showed downstaging to ≤ ypT2. Eighty-six (15.5%) patients achieved clinical complete regression (ypT0). In the multivariate logistic regression analysis, the factors cT category, BMI, ECOG score, CEA, histological type, extension in the rectum and year of the start of treatment were found to be independent factors for predicting downstaging to ≤ ypT2 after neoadjuvant chemoradiotherapy. The year of treatment initiation also remained an independent significant predictor for pathological complete regression. The prognosis was superior in patients with downstaging to ≤ ypT2 in terms of locoregional and distant recurrence as well as disease-free and overall survival. CONCLUSION Factors predicting downstaging after long-term nCRT could be identified. This may be helpful for counselling patients and selecting the optimal treatment for patients with advanced rectal carcinoma.
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Affiliation(s)
- Valerie K. B. Kohl
- Department of Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany ,Comprehensive Cancer Center Erlangen–European Metropolitan Area of Nuremberg (CCC ER-EMN), Erlangen, Germany
| | - Klaus Weber
- Department of Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany ,Comprehensive Cancer Center Erlangen–European Metropolitan Area of Nuremberg (CCC ER-EMN), Erlangen, Germany
| | - Maximilian Brunner
- Department of Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany ,Comprehensive Cancer Center Erlangen–European Metropolitan Area of Nuremberg (CCC ER-EMN), Erlangen, Germany
| | - Carol I. Geppert
- Comprehensive Cancer Center Erlangen–European Metropolitan Area of Nuremberg (CCC ER-EMN), Erlangen, Germany ,Institute of Pathology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Rainer Fietkau
- Comprehensive Cancer Center Erlangen–European Metropolitan Area of Nuremberg (CCC ER-EMN), Erlangen, Germany ,Department of Radiation Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Robert Grützmann
- Department of Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany ,Comprehensive Cancer Center Erlangen–European Metropolitan Area of Nuremberg (CCC ER-EMN), Erlangen, Germany
| | - Sabine Semrau
- Comprehensive Cancer Center Erlangen–European Metropolitan Area of Nuremberg (CCC ER-EMN), Erlangen, Germany ,Department of Radiation Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Susanne Merkel
- Department of Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany ,Comprehensive Cancer Center Erlangen–European Metropolitan Area of Nuremberg (CCC ER-EMN), Erlangen, Germany ,Department of Surgery, University Hospital Erlangen, Krankenhausstr. 12, 91054 Erlangen, Germany
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Impact of Cold Weather on Setup Errors in Radiotherapy. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:1463299. [PMID: 34804444 PMCID: PMC8601798 DOI: 10.1155/2021/1463299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/11/2021] [Accepted: 10/22/2021] [Indexed: 11/17/2022]
Abstract
Objective To investigate the influence of cold weather on setup errors of patients with chest and pelvic disease in radiotherapy. Methods The image-guided data of the patients were collected from the Radiotherapy Center of Cancer Hospital Affiliated to Guangxi Medical University from October 2020 to February 2021. During this period, the cold weather days were December 15, 16, and 17, 2020, and January 7 and 8, 2021. For body fixation in radiotherapy, an integrated plate and a thermoplastic mold were employed in 18 patients with chest disease, while an integrated plate and a vacuum pad were applied in 19 patients with pelvic disease. All patients underwent cone beam computed tomography (CBCT) scans in the first five treatments and once a week thereafter. The obtained data were registered to the planning CT image to get the setup errors of the patient in the translational direction including X, Y, and Z axes and rotational direction including R X , R Y , and R Z . Then, the Mann-Whitney U test was performed. The expansion boundary values of the chest and pelvis were calculated according to the formula M PTV=2.5∑+0.7δ. Results A total of 286 eligible results of CBCT scans were collected. There were 138 chest CBCT scans, including 26 taken in cold weather and 112 in usual weather, and 148 pelvic CBCT scans, including 33 taken in cold weather and 115 in usual weather. The X-, Y-, and Z-axis translational setup errors of patients with chest disease in the cold weather group were 0.16 (0.06, 0.32) cm, 0.25 (0.17, 0.52) cm, and 0.35 (0.21, 0.47) cm, respectively, and those in the usual weather group were 0.14 (0.08, 0.29) cm, 0.23 (0.13, 0.37) cm, and 0.18 (0.1, 0.35) cm, respectively. The results indicated that there was a statistical difference in the Z-axis translational error between the cold weather group and the usual weather group (U = 935.5; p=0.005 < 0.05), while there was no statistical difference in the rotational error between the two groups. The external boundary values of X, Y, and Z axes in the cold weather group were 0.57 cm, 0.92 cm, and 0.99 cm, respectively, and those in the usual weather group were 0.57 cm, 0.78 cm, and 0.68 cm, respectively. There was no significant difference in the translational and rotational errors of patients with pelvic disease between the cold weather group and the usual weather group (p < 0.05). The external boundary values of X, Y, and Z axes were 0.63 cm, 0.79 cm, and 0.68 cm in the cold weather group and 0.61 cm, 0.79 cm, and 0.61 cm in the usual weather group, respectively. Conclusion The setup error of patients undergoing radiotherapy with their bodies fixed by an integrated plate and a thermoplastic mold was greater in cold weather than in usual weather, especially in the ventrodorsal direction.
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Chen H, Liu L, Wang H, Shao Y, Gu H, Duan Y, Feng A, Huang Y, Xu Z. Influence of Clinical and Tumor Factors on Interfraction Setup Errors With Rotation Correction for Vacuum Cushion in Lung Stereotactic Body Radiation Therapy. Front Oncol 2021; 11:734709. [PMID: 34745956 PMCID: PMC8570303 DOI: 10.3389/fonc.2021.734709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/29/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose To explore the influence of clinical and tumor factors over interfraction setup errors with rotation correction for non-small cell lung cancer (NSCLC) stereotactic body radiation therapy (SBRT) patients immobilized in vacuum cushion (VC) to better understand whether patient re-setup could further be optimized with these parameters. Materials and Methods This retrospective study was conducted on 142 NSCLC patients treated with SBRT between November 2017 to July 2019 in the local institute. Translation and rotation setup errors were analyzed in 732 cone-beam computed tomography (CBCT) scans before treatment. Differences between groups were analyzed using independent sample t-test. Logistic regression test was used to analyze possible correlations between patient re-setup and clinical and tumor factors. Results Mean setup errors were the largest in anterior-posterior (AP) direction (3.2 ± 2.4 mm) compared with superior-inferior (SI) (2.8 ± 2.1 mm) and left-right (LR) (2.5 ± 2.0 mm) directions. The mean values were similar in pitch, roll, and rtn directions. Of the fractions, 83.7%, 90.3%, and 86.6% satisfied setup error tolerance limits in AP, SI, and LR directions, whereas 95% had rotation setup errors of <2° in the pitch, roll, or rtn directions. Setup errors were significantly different in the LR direction when age, body mass index (BMI), and "right vs. left" location parameters were divided into groups. Both univariate and multivariable model analyses showed that age (p = 0.006) and BMI (p = 0.002) were associated with patient re-setup. Conclusions Age and BMI, as clinical factors, significantly influenced patient re-setup in the current study, whereas all other clinical and tumor factors were not correlated with patient re-setup. The current study recommends that more attention be paid to setup for elderly patients and patients with larger BMI when immobilized using VC, especially in the left-right direction.
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Affiliation(s)
- Hua Chen
- Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Lingxiang Liu
- Department of Oncology, Guangzhou Panyu Central Hospital, Guangzhou, China
| | - Hao Wang
- Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Yan Shao
- Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Hengle Gu
- Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Yanhua Duan
- Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Aihui Feng
- Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Ying Huang
- Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Zhiyong Xu
- Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
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Novak J, Du D, Shinde A, Li R, Amini A, Chen YJ, Wong J, Han C, Neylon J, Liu A, Glaser S. Setup Accuracy in Craniospinal Irradiation: Implications for Planning Treatment Volume Margins. Adv Radiat Oncol 2021; 6:100747. [PMID: 34646966 PMCID: PMC8498716 DOI: 10.1016/j.adro.2021.100747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 05/19/2021] [Accepted: 06/23/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose Craniospinal irradiation (CSI) using tomotherapy has advantages over standard 3-dimensional techniques. However, there is a paucity of published data on craniospinal setup reproducibility to guide appropriate planning treatment volume (PTV) margins. We sought to evaluate the setup accuracy of patients undergoing CSI to optimize PTV margins. Methods and Materials We measured residual setup deviation between simulation computed tomography (CT) and daily megavoltage CT after couch shifts made by therapists after megavoltage CT-based image registration for 10 patients who completed CSI at our institution. Translational displacement values were recorded at the sella, top of T1, and top of L5 in the anteroposterior (AP) and lateral planes. Systematic and random error were calculated from displacement values. Using z score analysis, we calculated minimal PTV margins to encompass 90% of recorded fractions at each level. We evaluated whether patient characteristics predict for increased setup error using standard statistical techniques. Results The mean setup deviation in the AP plane across all treatments was 2.49, 3.40, and 3.83 mm at the sella, T1, and L5, respectively. Mean lateral setup error was 2.86, 4.02, and 5.46 mm at the sella, T1, and L5, respectively. Systematic error ranged from 0.75 to 1.01 mm at the sella, 1.09 to 1.37 mm at T1, and 1.30 to 1.50 mm at L5. Random error ranged from 1.35 to 1.41 mm at the sella, 1.48 to 1.73 mm at T1, and 2.26 to 2.37 mm at L5. The minimum margin to cover 90% of the treatments was 6.4, 8.2, and 10.5 mm at the sella, T1, and L5, respectively. There appeared to be a correlation between older age and lateral setup error in the L spine approaching statistical significance (R, 0.629; P = .052). Conclusions Setup error increases in the caudal direction of the spine and is greater in the lateral plane compared with the AP plane. We recommend a PTV margin of 5 to 7 mm in the brain and 10 mm in the spine.
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Affiliation(s)
- Jennifer Novak
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California
| | - Dongsu Du
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California
| | - Ashwin Shinde
- Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Richard Li
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California
| | - Arya Amini
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California
| | - Yi-Jen Chen
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California
| | - Jeffrey Wong
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California
| | - Chunhui Han
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California
| | - John Neylon
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, California
| | - An Liu
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California
| | - Scott Glaser
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California
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Weiss E, Deng X, Mukhopadhyay N, Jan N. Effects of the recurrence pattern on patient survival following SABR for stage I lung cancer. Acta Oncol 2020; 59:427-433. [PMID: 31928266 DOI: 10.1080/0284186x.2019.1711172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: Information on the effect of the recurrence pattern on survival for stage I lung cancer following stereotactic ablative radiotherapy (SABR) is limited.Materials and Methods: The recurrence pattern was analyzed for 100 consecutive stage I non-small-cell lung cancer patients treated with SABR using predominantly 12 Gy × 4. Recurrences were classified as local, regional lymph nodes and distant. Distant recurrences included recurrences in the lung and outside the chest. Single lung recurrences were named solitary, if no other location was involved. Kaplan-Meier survival estimates were calculated for different locations of recurrence. Clinical and dosimetrical factors affecting survival were also analyzed.Results: Median follow-up was 32 months (3-123), median age 70 years (49-95). In total, 31 patients had recurrences after a median 21 months (4-60): 5 local; 10 regional; 8 distant outside the chest; 25 non-local lung recurrences, of which 15 were single - 10 of which solitary - and 10 multiple lung nodules. Patients with a solitary lung recurrence had longer survival compared to local or distant recurrences (p = .04 each), and compared to multiple lung nodules (p = .09). 3-year local recurrence-free survival was 92%, disease-free survival 69% and overall survival 59%. On multivariate analysis, disease-free survival was associated with statin use (p = .038) and tumor location (p = .035). Smoking history predicted overall survival (p < .0006).Conclusions: A total of 81% of recurrences involved the lungs. Patients with solitary lung recurrences/second primary lung cancers had the longest overall survival suggesting definitive treatment should be considered. The effects of statin use need to be explored further.
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Affiliation(s)
- Elisabeth Weiss
- Department of Radiation Oncology, Virginia Commonwealth University Health, Richmond, VA, USA
| | - Xiaoyan Deng
- Department of Biostatistics, Virginia Commonwealth University Health, Richmond, VA, USA
| | - Nitai Mukhopadhyay
- Department of Biostatistics, Virginia Commonwealth University Health, Richmond, VA, USA
| | - Nuzhat Jan
- Department of Radiation Oncology, Virginia Commonwealth University Health, Richmond, VA, USA
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