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大学・研究所にある論文を検索できる 「Tumor volume shrinkage during stereotactic body radiotherapy is related to better prognoses in patients with stage I non-small-cell lung cancer」の論文概要。リケラボ論文検索は、全国の大学リポジトリにある学位論文・教授論文を一括検索できる論文検索サービスです。
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Tumor volume shrinkage during stereotactic body radiotherapy is related to better prognoses in patients with stage I non-small-cell lung cancer

VU HONG NAM 山梨大学 DOI:info:doi/10.34429/00005159

2022.03.18

概要

Objectives: The tumor volumetric change during treatment may reflect biological sensitivity and could be used as a predictive factor for patients’ prognoses. The purpose of the study was to investigate the association between tumor volume changes during stereotactic body radiation therapy (SBRT) and prognoses in stage I non-small-cell lung cancer (NSCLC).

Materials and methods:
・Patients and study design: Patients diagnosed stage I non-small cell lung cancer, treated by SBRT from January 2006 to December 2008, were retrospectively reviewed. Eligibility criteria of the study were as follows: (1) histologically confirmed primary NSCLC; (2) T1N0M0 or T2N0M0 disease (3) greatest tumor dimension ≤ 5 cm; (4) World Health Organization performance status (PS) ≤ 2; (5) no prior chest radiotherapy for the NSCLC.
・Treatment Methods: SBRT was performed with a total dose of 48.0-50.5 Gy in 4-5 fractions.
The tumor’s volumes were calculated with a treatment planning system (MIM 6.6.8 Image　analysis soft-wear) and compared between the simulation CT and the CT taken at the last treatment session using CT-on rail system.
Contouring Protocol: Target delineation (GTV) was performed by the attending physician using MIM 6.6.8 treatment planning system with a standard CT lung window.
Tumor volume change (%) = (Volume last day – Volume simulation day)/ Volume simulation day Statistical analysis: Kaplan–Meier with the log-rank test to compare the curves of Overall Survival (OS), Local Control (LC), Lymph-Node metastasis (LN), and Distant Metastatic (DM). Cox proportional hazards model for multivariate analysis.

Results: A total of 98 patients with a mean age of 78.6 years were enrolled in the study. The T-stage was T1a in 42%, T1b in 32%, and T2a in 26% of the cases.
Tumor volume change during SBRT period: The gross tumor volume (GTV) shrank and increased ≥ 10% in 23 (23.5%) and 36 (36.7%) of the cases, respectively.

Clinical outcomes: Median follow-up was 74 months (0.1-119 months). Five-year estimated outcomes were overall survival, 57.9% (95% CI, 56.1% - 73.2%); local control, 77.2% (95%CI, 58.6%-85.2%). Correlation between volume tumor changes and clinical outcomes: The 5-year local control and overall survival rates in the group of tumor shrinkage more than 10% were significantly higher than those in the group of tumor shrinkage less than 10%, e. g 94.7% vs 70.8%; 85.4% vs 47.6% respectively with the p-value < 0.05 in all the categories.
Univariate and multivariate analyses for OS and local control: Medical operability and tumor volume change significantly (P < 0.05) relative to OS, whereas tumor volume, tumor volume change, and BED are related to local control in univariate analysis. However, in multivariate analysis, medical operability, and tumor volume change significantly relative to OS, while only tumor volume changes are related to local control.

Discussion: The tumor shrinkage rapidly during short course of SBRT could be explained by the tumor sensitivity to radiation, especially due to tumor cell apoptosis. There is evidence that cohort of patients with adenocarcinoma subtype of NSCLC and tumor-infiltrating lymphocytes (TILs) has better prognoses over other cohorts of NSCLC. These cells are radiosensitive and easily undergo apoptosis. Therefore, loss of tumor cells and lymphocytes could induce the decrease of tumor volume during SBRT period. Besides, the cut-off value of 10% was chosen based on many articles relating tumor change with SBRT treatment, and it could be simple in clinical application. Furthermore, tumor enlarged more than 10% during treatment due to edema could lead insufficient of GTV dose coverage and result in worse outcomes. In contrary, tumor remarkably decreased in size may receive better dose coverage and get higher rates of OS and Local control.

Conclusions: Half of cases have the change of tumor volume at least 10% during SBRT period. Tumor’s shrinkage more than 10% during SBRT period may have better prognosis (Overall survival, Local Control) in early-stage NSCLC patients.

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参考文献

1. Onishi H, Shirato H, Nagata Y et al. Stereotactic body radiother- apy (SBRT) for operable stage I non–small-cell lung cancer: Can SBRT be comparable to surgery? Int J Radiat Oncol Biol Phys. 2011;81:1352–8.

2. Tandberg DJ, Tong BC, Ackerson BG et al. Surgery versus stereo- tactic body radiation therapy for stage I non–small cell lung can- cer: A comprehensive review. Cancer. 2018;124:667–78.

3. Chang JY, Liu H, Balter P et al. Clinical outcome and predictors of survival and pneumonitis after stereotactic ablative radiotherapy for stage I non-small cell lung cancer. Radiat Oncol. 2012;7:152.

4. Matsuo Y, Shibuya K, Nagata Y et al. Prognostic factors in stereo- tactic body radiotherapy for non–small-cell lung cancer. Int J Radiat Oncol Biol Phys. 2011;79:1104–11.

5. Shirata Y, Jingu K, Koto M et al. Prognostic factors for local control of stage I non-small cell lung cancer in stereotactic radiotherapy: A retrospective analysis. Radiat Oncol. 2012;7:182.746 • N. Vu et al.

6. Chi A, Liao Z, Nguyen NP et al. Systemic review of the patterns of failure following stereotactic body radiation therapy in early-stage non-small-cell lung cancer: Clinical implications. Radiother Oncol. 2010;94:1–11.

7. Tatekawa K, Iwata H, Kawaguchi T et al. Changes in volume of stage I non-small-cell lung cancer during stereotactic body radio- therapy. Radiat Oncol. 2014;9:8.

8. Salamekh S, Rong Y, Ayan AS et al. Inter-fraction tumor volume response during lung stereotactic body radiation therapy corre- lated to patient variables. PloS one. 2016;11:e0153245.

9. Brinkman KL, Teh BS, Xu B. A review of stereotactic body radi- ation therapy (SBRT) from the molecular radiobiology perspec- tive. J Radiat Oncol. 2012;1:311–6.

10. Senan S, Palma DA, Lagerwaard FJ. Stereotactic ablative radio- therapy for stage I NSCLC: Recent advances and controversies. J Thorac Dis. 2011;3:189.

11. Onishi H, Kuriyama K, Komiyama T et al. A new irradiation system for lung cancer combining linear accelerator, computed tomography, patient self-breath-holding, and patient-directed beam-control without respiratory monitoring devices. IntJ Radiat Oncol Biol Phys. 2003;56:14–20.

12. Onishi H, Kawakami H, Marino K et al. A simple respiratory indicator for irradiation during voluntary breath holding: A one- touch device without electronic materials. Radiology. 2010;255: 917–23.

13. Onishi H, Araki T, Shirato H et al. Stereotactic hypofractionated high-dose irradiation for stage I nonsmall cell lung carcinoma: Clinical outcomes in 245 subjects in a Japanese multiinstitutional study. Cancer. 2004;101:1623–31.

14. Kuriyama K, Onishi H, Sano N et al. A new irradiation unit con- structed of self-moving gantry-CT and linac. IntJRadiat Oncol Biol Phys. 2003;55:428–35.

15. Onishi H, Kuriyama K, Komiyama T et al. CT evaluation of patient deep inspiration self-breath-holding: How precisely can patients reproduce the tumor position in the absence of respira- tory monitoring devices? Med Phys. 2003;30:1183–7.

16. Onimaru R, Fujino M, Yamazaki K et al. Steep dose–response relationship for stage I non–small-cell lung cancer using hypofrac- tionated high-dose irradiation by real-time tumor-tracking radio- therapy. IntJ Radiat Oncol Biol Phys. 2008;70:374–81.

17. King K, Mayekar S, Marwaha G et al. Interfraction tumor size changes during lung SBRT: What factors matter? IntJRadiat Oncol Biol Phys. 2017;99:E469–70.

18. Ashworth AB, Senan S, Palma DA et al. An individual patient data metaanalysis of outcomes and prognostic factors after treatment of oligometastatic non–small-cell lung cancer. Clin Lung Cancer. 2014;15:346–55.

19. Koike T, Tsuchiya R, Goya T et al. Prognostic factors in 3315 completely resected cases of clinical stage I non-small cell lung cancer in Japan. J Thorac Oncol. 2007;2:408–13.

20. Hoopes DJ, Tann M, Fletcher JW et al. FDG-PET and stereotactic body radiotherapy (SBRT) for stage I non-small-cell lung cancer. Lung cancer. 2007;56:229–34.

21. Henderson MA, Hoopes DJ, Fletcher JW et al. A pilot trial of serial 18F-fluorodeoxyglucose positron emission tomography in patients with medically inoperable stage I non–small-cell lung cancer treated with hypofractionated stereotactic body radiother- apy. IntJ Radiat Oncol Biol Phys. 2010;76:789–95.

22. Burdick MJ, Stephans KL, Reddy CA et al. Maximum standard- ized uptake value from staging FDG-PET/CT does not predict treatment outcome for early-stage non–small-cell lung cancer treated with stereotactic body radiotherapy. IntJ Radiat Oncol Biol Phys. 2010;78:1033–9.

23. Goodgame B, Pillot GA, Yang Z et al. Prognostic value of preoper- ative positron emission tomography in resected stage I non-small cell lung cancer. J Thorac Oncol. 2008;3:130–4.

24. Shibamoto Y, Ike O, Mizuno H et al. Proliferative activity and micronucleus frequency after radiation of lung cancer cells as assessed by the cytokinesis-block method and their relationship to clinical outcome. Clin Cancer Res. 1998;4:677–82.

25. Meyn R, Stephens L, Ang K-K et al. Heterogeneity in the devel- opment of apoptosis in irradiated murine tumours of different his- tologies. International journal of radiation biology. 1993;64:583–91.

26. Feng W, Li Y, Shen L et al. Prognostic value of tumor-infiltrating lymphocytes for patients with completely resected stage IIIA (N2) non-small cell lung cancer. Oncotarget. 2016;7:7227.

27. Underberg RW, Lagerwaard FJ, Van Tinteren H et al. Time trends in target volumes for stage I non–small-cell lung can- cer after stereotactic radiotherapy. Int J Radiat Oncol Biol Phys. 2006;64:1221–8.

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