View in EDS

Computed Tomography-Based Anatomic Assessment Overestimates Local Tumor Recurrence in Patients With Mass-like Consolidation After Stereotactic Body Radiotherapy for Early-Stage Non-Small Cell Lung Cancer

Saved in:
Bibliographic Details
Title: Computed Tomography-Based Anatomic Assessment Overestimates Local Tumor Recurrence in Patients With Mass-like Consolidation After Stereotactic Body Radiotherapy for Early-Stage Non-Small Cell Lung Cancer
Authors: Dunlap, Neal E.1, Yang, Wensha2, McIntosh, Alyson3, Sheng, Ke4, Benedict, Stanley H.5, Read, Paul W.5, Larner, James M.5 jml2p@virginia.edu
Source: International Journal of Radiation Oncology, Biology, Physics. Dec2012, Vol. 84 Issue 5, p1071-1077. 7p.
Subjects: Cancer tomography, Cancer relapse, Stereotaxic techniques, Cancer radiotherapy, Fibrosis, Medical statistics, Follow-up studies (Medicine)
Abstract: Purpose: To investigate pulmonary radiologic changes after lung stereotactic body radiotherapy (SBRT), to distinguish between mass-like fibrosis and tumor recurrence. Methods and Materials: Eighty consecutive patients treated with 3- to 5-fraction SBRT for early-stage peripheral non-small cell lung cancer with a minimum follow-up of 12 months were reviewed. The mean biologic equivalent dose received was 150 Gy (range, 78-180 Gy). Patients were followed with serial CT imaging every 3 months. The CT appearance of consolidation was defined as diffuse or mass-like. Progressive disease on CT was defined according to Response Evaluation Criteria in Solid Tumors 1.1. Positron emission tomography (PET) CT was used as an adjunct test. Tumor recurrence was defined as a standardized uptake value equal to or greater than the pretreatment value. Biopsy was used to further assess consolidation in select patients. Results: Median follow-up was 24 months (range, 12.0-36.0 months). Abnormal mass-like consolidation was identified in 44 patients (55%), whereas diffuse consolidation was identified in 12 patients (15%), at a median time from end of treatment of 10.3 months and 11.5 months, respectively. Tumor recurrence was found in 35 of 44 patients with mass-like consolidation using CT alone. Combined with PET, 10 of the 44 patients had tumor recurrence. Tumor size (hazard ratio 1.12, P=.05) and time to consolidation (hazard ratio 0.622, P=.03) were predictors for tumor recurrence. Three consecutive increases in volume and increasing volume at 12 months after treatment in mass-like consolidation were highly specific for tumor recurrence (100% and 80%, respectively). Patients with diffuse consolidation were more likely to develop grade ≥2 pneumonitis (odds ratio 26.5, P=.02) than those with mass-like consolidation (odds ratio 0.42, P=.07). Conclusion: Incorporating the kinetics of mass-like consolidation and PET to the current criteria for evaluating posttreatment response will increase the likelihood of correctly identifying patients with progressive disease after lung SBRT. [Copyright &y& Elsevier]
Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Engineering Source
FullText Text:
  Availability: 0
Header DbId: egs
DbLabel: Engineering Source
An: 83296686
AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Computed Tomography-Based Anatomic Assessment Overestimates Local Tumor Recurrence in Patients With Mass-like Consolidation After Stereotactic Body Radiotherapy for Early-Stage Non-Small Cell Lung Cancer
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Dunlap%2C+Neal+E%2E%22">Dunlap, Neal E.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Yang%2C+Wensha%22">Yang, Wensha</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22McIntosh%2C+Alyson%22">McIntosh, Alyson</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Sheng%2C+Ke%22">Sheng, Ke</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Benedict%2C+Stanley+H%2E%22">Benedict, Stanley H.</searchLink><relatesTo>5</relatesTo><br /><searchLink fieldCode="AR" term="%22Read%2C+Paul+W%2E%22">Read, Paul W.</searchLink><relatesTo>5</relatesTo><br /><searchLink fieldCode="AR" term="%22Larner%2C+James+M%2E%22">Larner, James M.</searchLink><relatesTo>5</relatesTo><i> jml2p@virginia.edu</i>
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="JN" term="%22International+Journal+of+Radiation+Oncology%2C+Biology%2C+Physics%22">International Journal of Radiation Oncology, Biology, Physics</searchLink>. Dec2012, Vol. 84 Issue 5, p1071-1077. 7p.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Cancer+tomography%22">Cancer tomography</searchLink><br /><searchLink fieldCode="DE" term="%22Cancer+relapse%22">Cancer relapse</searchLink><br /><searchLink fieldCode="DE" term="%22Stereotaxic+techniques%22">Stereotaxic techniques</searchLink><br /><searchLink fieldCode="DE" term="%22Cancer+radiotherapy%22">Cancer radiotherapy</searchLink><br /><searchLink fieldCode="DE" term="%22Fibrosis%22">Fibrosis</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+statistics%22">Medical statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Follow-up+studies+%28Medicine%29%22">Follow-up studies (Medicine)</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Purpose: To investigate pulmonary radiologic changes after lung stereotactic body radiotherapy (SBRT), to distinguish between mass-like fibrosis and tumor recurrence. Methods and Materials: Eighty consecutive patients treated with 3- to 5-fraction SBRT for early-stage peripheral non-small cell lung cancer with a minimum follow-up of 12 months were reviewed. The mean biologic equivalent dose received was 150 Gy (range, 78-180 Gy). Patients were followed with serial CT imaging every 3 months. The CT appearance of consolidation was defined as diffuse or mass-like. Progressive disease on CT was defined according to Response Evaluation Criteria in Solid Tumors 1.1. Positron emission tomography (PET) CT was used as an adjunct test. Tumor recurrence was defined as a standardized uptake value equal to or greater than the pretreatment value. Biopsy was used to further assess consolidation in select patients. Results: Median follow-up was 24 months (range, 12.0-36.0 months). Abnormal mass-like consolidation was identified in 44 patients (55%), whereas diffuse consolidation was identified in 12 patients (15%), at a median time from end of treatment of 10.3 months and 11.5 months, respectively. Tumor recurrence was found in 35 of 44 patients with mass-like consolidation using CT alone. Combined with PET, 10 of the 44 patients had tumor recurrence. Tumor size (hazard ratio 1.12, P=.05) and time to consolidation (hazard ratio 0.622, P=.03) were predictors for tumor recurrence. Three consecutive increases in volume and increasing volume at 12 months after treatment in mass-like consolidation were highly specific for tumor recurrence (100% and 80%, respectively). Patients with diffuse consolidation were more likely to develop grade ≥2 pneumonitis (odds ratio 26.5, P=.02) than those with mass-like consolidation (odds ratio 0.42, P=.07). Conclusion: Incorporating the kinetics of mass-like consolidation and PET to the current criteria for evaluating posttreatment response will increase the likelihood of correctly identifying patients with progressive disease after lung SBRT. [Copyright &y& Elsevier]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=egs&AN=83296686
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1016/j.ijrobp.2012.01.088
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 7
        StartPage: 1071
    Subjects:
      – SubjectFull: Cancer tomography
        Type: general
      – SubjectFull: Cancer relapse
        Type: general
      – SubjectFull: Stereotaxic techniques
        Type: general
      – SubjectFull: Cancer radiotherapy
        Type: general
      – SubjectFull: Fibrosis
        Type: general
      – SubjectFull: Medical statistics
        Type: general
      – SubjectFull: Follow-up studies (Medicine)
        Type: general
    Titles:
      – TitleFull: Computed Tomography-Based Anatomic Assessment Overestimates Local Tumor Recurrence in Patients With Mass-like Consolidation After Stereotactic Body Radiotherapy for Early-Stage Non-Small Cell Lung Cancer
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Dunlap, Neal E.
      – PersonEntity:
          Name:
            NameFull: Yang, Wensha
      – PersonEntity:
          Name:
            NameFull: McIntosh, Alyson
      – PersonEntity:
          Name:
            NameFull: Sheng, Ke
      – PersonEntity:
          Name:
            NameFull: Benedict, Stanley H.
      – PersonEntity:
          Name:
            NameFull: Read, Paul W.
      – PersonEntity:
          Name:
            NameFull: Larner, James M.
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 12
              Text: Dec2012
              Type: published
              Y: 2012
          Identifiers:
            – Type: issn-print
              Value: 03603016
          Numbering:
            – Type: volume
              Value: 84
            – Type: issue
              Value: 5
          Titles:
            – TitleFull: International Journal of Radiation Oncology, Biology, Physics
              Type: main
ResultId 1