1. Prognostic impact of gross tumor volume during radical radiochemotherapy of locally advanced non-small cell lung cancer-results from the NCT03055715 multicenter cohort study of the Young DEGRO Trial Group
- Author
-
Ostheimer, C., Maeurer, M., Ebert, N., Schmitt, D., Krug, D., Baumann, R., Henkenberens, C., Giordano, F. A., Sautter, L., Lopez, Guerra, Fleischmann, D. F., Niyazi, M., Kasmann, L., Kaul, D., Thieme, A. H., Billiet, C., Dobiasch, S., Arnold, C. R., Oertel, M., Haussmann, J., Gauer, T., Goy, Y., Suess, C., Ziegler, S., Panje, C. M., Baues, C., Trommer-Nestler, M., Skripcak, T., Medenwald, D., Ostheimer, C., Maeurer, M., Ebert, N., Schmitt, D., Krug, D., Baumann, R., Henkenberens, C., Giordano, F. A., Sautter, L., Lopez, Guerra, Fleischmann, D. F., Niyazi, M., Kasmann, L., Kaul, D., Thieme, A. H., Billiet, C., Dobiasch, S., Arnold, C. R., Oertel, M., Haussmann, J., Gauer, T., Goy, Y., Suess, C., Ziegler, S., Panje, C. M., Baues, C., Trommer-Nestler, M., Skripcak, T., and Medenwald, D.
- Abstract
Background In radical radiochemotherapy (RCT) of inoperable non-small-cell lung cancer (NSCLC) typical prognostic factors include T- and N-stage, while there are still conflicting data on the prognostic relevance of gross tumor volume (GTV) and particularly its changes during RCT. The NCT03055715 study of the Young DEGRO working group of the German Society of Radiation Oncology (DEGRO) evaluated the prognostic impact of GTV and its changes during RCT. Methods A total of 21 university centers for radiation oncology from five different European countries (Germany, Switzerland, Spain, Belgium, and Austria) participated in the study which evaluated n = 347 patients with confirmed (biopsy) inoperable NSCLC in UICC stage III A/B who received radical curative-intent RCT between 2010 and 2013. Patient and disease data were collected anonymously via electronic case report forms and entered into the multi-institutional RadPlanBio platform for central data analysis. GTV before RCT (initial planning CT, GTV1) and at 40-50 Gy (re-planning CT for radiation boost, GTV2) was delineated. Absolute GTV before/during RCT and relative GTV changes were correlated with overall survival as the primary endpoint. Hazard ratios (HR) of survival analysis were estimated by means of adjusted Cox regression models. Results GTV1 was found to have a mean of 154.4 ml (95%CI: 1.5-877) and GTV2 of 106.2 ml (95% CI: 0.5-589.5), resulting in an estimated reduction of 48.2 ml (p < 0.001). Median overall survival (OS) was 18.8 months with a median of 22.1, 20.9, and 12.6 months for patients with high, intermediate, and low GTV before RT. Considering all patients, in one survival model of overall mortality, GTV2 (2.75 (1.12-6.75, p = 0.03) was found to be a stronger survival predictor than GTV1 (1.34 (0.9-2, p > 0.05). In patients with available data on both GTV1 and GTV2, absolute GTV1 before RT was not significantly associated with survival (HR 0-69, 0.32-1.49, p > 0.05) but GTV2 significantly predicted
- Published
- 2021