Differential analysis of local and regional failure in locally advanced non-small cell lung cancer patients treated with concurrent chemoradiotherapy

Judi N A van Diessen; Chun Chen; Michel M van den Heuvel; José S A Belderbos; Jan-Jakob Sonke

doi:10.1016/j.radonc.2016.02.008

Differential analysis of local and regional failure in locally advanced non-small cell lung cancer patients treated with concurrent chemoradiotherapy

Judi N A van Diessen
, Chun Chen
, Michel M van den Heuvel
, José S A Belderbos
, Jan-Jakob Sonke

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

Abstract

BACKGROUND AND PURPOSE: Concurrent chemoradiotherapy (CCRT) is the standard treatment in locally advanced non-small cell lung cancer (NSCLC) patients. In clinical practice, the primary tumor (PT) and involved lymph nodes (LNs) receive the same radiotherapy dose. This study investigates differences between local failure (LF) and regional failure (RF).

MATERIAL AND METHODS: Patients were irradiated with 66 Gy in 24 fractions (using IMRT) combined with daily low dose cisplatin. The PT and LNs were contoured on the planning CT-scan registered with a (18)FDG-PET-scan. Log10(Volume) and SUVmax of PT and LNs, location (LNs versus PT), performance status, age and gender were tested as prognostic factors for lesion failure using cox regression analysis.

RESULTS: In total, 226 patients were analyzed. LF or RF as first event was seen in 37 PT (16%) and 14 LNs (6%). Log10(Volume), location and SUVmax were significantly associated with failure in univariate analysis. In multivariate analysis, only log10(Volume) remained as a significant factor.

CONCLUSIONS: A LF and RF as first event of respectively 16% and 6% were observed in locally advanced NSCLC patients treated with CCRT. This difference was primarily associated with the difference in log10(Volume) of the primary tumor and lymph nodes.

Original language	English
Pages (from-to)	447-52
Number of pages	6
Journal	Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
Volume	118
Issue number	3
DOIs	https://doi.org/10.1016/j.radonc.2016.02.008
Publication status	Published - Mar 2016
Externally published	Yes

Keywords

Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols/therapeutic use
Carcinoma, Non-Small-Cell Lung/pathology
Cetuximab/administration & dosage
Chemoradiotherapy/methods
Cisplatin/administration & dosage
Dose-Response Relationship, Drug
Female
Fluorodeoxyglucose F18
Humans
Kaplan-Meier Estimate
Lung Neoplasms/pathology
Lymph Nodes/pathology
Lymphatic Metastasis
Male
Middle Aged
Positron-Emission Tomography/methods
Radiopharmaceuticals
Tomography, X-Ray Computed
Treatment Failure
Tumor Burden

Access to Document

10.1016/j.radonc.2016.02.008

Cite this

van Diessen, J. N. A., Chen, C., van den Heuvel, M. M., Belderbos, J. S. A., & Sonke, J.-J. (2016). Differential analysis of local and regional failure in locally advanced non-small cell lung cancer patients treated with concurrent chemoradiotherapy. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 118(3), 447-52. https://doi.org/10.1016/j.radonc.2016.02.008

@article{7c87756a571548658af622bd51d1c8ef,

title = "Differential analysis of local and regional failure in locally advanced non-small cell lung cancer patients treated with concurrent chemoradiotherapy",

abstract = "BACKGROUND AND PURPOSE: Concurrent chemoradiotherapy (CCRT) is the standard treatment in locally advanced non-small cell lung cancer (NSCLC) patients. In clinical practice, the primary tumor (PT) and involved lymph nodes (LNs) receive the same radiotherapy dose. This study investigates differences between local failure (LF) and regional failure (RF).MATERIAL AND METHODS: Patients were irradiated with 66 Gy in 24 fractions (using IMRT) combined with daily low dose cisplatin. The PT and LNs were contoured on the planning CT-scan registered with a (18)FDG-PET-scan. Log10(Volume) and SUVmax of PT and LNs, location (LNs versus PT), performance status, age and gender were tested as prognostic factors for lesion failure using cox regression analysis.RESULTS: In total, 226 patients were analyzed. LF or RF as first event was seen in 37 PT (16\%) and 14 LNs (6\%). Log10(Volume), location and SUVmax were significantly associated with failure in univariate analysis. In multivariate analysis, only log10(Volume) remained as a significant factor.CONCLUSIONS: A LF and RF as first event of respectively 16\% and 6\% were observed in locally advanced NSCLC patients treated with CCRT. This difference was primarily associated with the difference in log10(Volume) of the primary tumor and lymph nodes.",

keywords = "Adult, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Carcinoma, Non-Small-Cell Lung/pathology, Cetuximab/administration \& dosage, Chemoradiotherapy/methods, Cisplatin/administration \& dosage, Dose-Response Relationship, Drug, Female, Fluorodeoxyglucose F18, Humans, Kaplan-Meier Estimate, Lung Neoplasms/pathology, Lymph Nodes/pathology, Lymphatic Metastasis, Male, Middle Aged, Positron-Emission Tomography/methods, Radiopharmaceuticals, Tomography, X-Ray Computed, Treatment Failure, Tumor Burden",

author = "\{van Diessen\}, \{Judi N A\} and Chun Chen and \{van den Heuvel\}, \{Michel M\} and Belderbos, \{Jos{\'e} S A\} and Jan-Jakob Sonke",

year = "2016",

month = mar,

doi = "10.1016/j.radonc.2016.02.008",

language = "English",

volume = "118",

pages = "447--52",

journal = "Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology",

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number = "3",

}

van Diessen, JNA, Chen, C, van den Heuvel, MM, Belderbos, JSA & Sonke, J-J 2016, 'Differential analysis of local and regional failure in locally advanced non-small cell lung cancer patients treated with concurrent chemoradiotherapy', Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, vol. 118, no. 3, pp. 447-52. https://doi.org/10.1016/j.radonc.2016.02.008

Differential analysis of local and regional failure in locally advanced non-small cell lung cancer patients treated with concurrent chemoradiotherapy. / van Diessen, Judi N A; Chen, Chun; van den Heuvel, Michel M et al.
In: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, Vol. 118, No. 3, 03.2016, p. 447-52.

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

TY - JOUR

T1 - Differential analysis of local and regional failure in locally advanced non-small cell lung cancer patients treated with concurrent chemoradiotherapy

AU - van Diessen, Judi N A

AU - Chen, Chun

AU - van den Heuvel, Michel M

AU - Belderbos, José S A

AU - Sonke, Jan-Jakob

PY - 2016/3

Y1 - 2016/3

N2 - BACKGROUND AND PURPOSE: Concurrent chemoradiotherapy (CCRT) is the standard treatment in locally advanced non-small cell lung cancer (NSCLC) patients. In clinical practice, the primary tumor (PT) and involved lymph nodes (LNs) receive the same radiotherapy dose. This study investigates differences between local failure (LF) and regional failure (RF).MATERIAL AND METHODS: Patients were irradiated with 66 Gy in 24 fractions (using IMRT) combined with daily low dose cisplatin. The PT and LNs were contoured on the planning CT-scan registered with a (18)FDG-PET-scan. Log10(Volume) and SUVmax of PT and LNs, location (LNs versus PT), performance status, age and gender were tested as prognostic factors for lesion failure using cox regression analysis.RESULTS: In total, 226 patients were analyzed. LF or RF as first event was seen in 37 PT (16%) and 14 LNs (6%). Log10(Volume), location and SUVmax were significantly associated with failure in univariate analysis. In multivariate analysis, only log10(Volume) remained as a significant factor.CONCLUSIONS: A LF and RF as first event of respectively 16% and 6% were observed in locally advanced NSCLC patients treated with CCRT. This difference was primarily associated with the difference in log10(Volume) of the primary tumor and lymph nodes.

AB - BACKGROUND AND PURPOSE: Concurrent chemoradiotherapy (CCRT) is the standard treatment in locally advanced non-small cell lung cancer (NSCLC) patients. In clinical practice, the primary tumor (PT) and involved lymph nodes (LNs) receive the same radiotherapy dose. This study investigates differences between local failure (LF) and regional failure (RF).MATERIAL AND METHODS: Patients were irradiated with 66 Gy in 24 fractions (using IMRT) combined with daily low dose cisplatin. The PT and LNs were contoured on the planning CT-scan registered with a (18)FDG-PET-scan. Log10(Volume) and SUVmax of PT and LNs, location (LNs versus PT), performance status, age and gender were tested as prognostic factors for lesion failure using cox regression analysis.RESULTS: In total, 226 patients were analyzed. LF or RF as first event was seen in 37 PT (16%) and 14 LNs (6%). Log10(Volume), location and SUVmax were significantly associated with failure in univariate analysis. In multivariate analysis, only log10(Volume) remained as a significant factor.CONCLUSIONS: A LF and RF as first event of respectively 16% and 6% were observed in locally advanced NSCLC patients treated with CCRT. This difference was primarily associated with the difference in log10(Volume) of the primary tumor and lymph nodes.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Antineoplastic Combined Chemotherapy Protocols/therapeutic use

KW - Carcinoma, Non-Small-Cell Lung/pathology

KW - Cetuximab/administration & dosage

KW - Chemoradiotherapy/methods

KW - Cisplatin/administration & dosage

KW - Dose-Response Relationship, Drug

KW - Female

KW - Fluorodeoxyglucose F18

KW - Humans

KW - Kaplan-Meier Estimate

KW - Lung Neoplasms/pathology

KW - Lymph Nodes/pathology

KW - Lymphatic Metastasis

KW - Male

KW - Middle Aged

KW - Positron-Emission Tomography/methods

KW - Radiopharmaceuticals

KW - Tomography, X-Ray Computed

KW - Treatment Failure

KW - Tumor Burden

U2 - 10.1016/j.radonc.2016.02.008

DO - 10.1016/j.radonc.2016.02.008

M3 - Article

C2 - 26900092

SN - 0167-8140

VL - 118

SP - 447

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JO - Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

JF - Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

IS - 3

ER -

van Diessen JNA, Chen C, van den Heuvel MM, Belderbos JSA, Sonke JJ. Differential analysis of local and regional failure in locally advanced non-small cell lung cancer patients treated with concurrent chemoradiotherapy. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. 2016 Mar;118(3):447-52. doi: 10.1016/j.radonc.2016.02.008

Differential analysis of local and regional failure in locally advanced non-small cell lung cancer patients treated with concurrent chemoradiotherapy

Abstract

Keywords

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