Modern imaging technique assessment of small cell lung cancer doubling time
| Autor: | Janice Maria Walshe, Raymond S. McDermott, Mohd Syahizul Nuhairy Mohd Sharial, Mark Doherty, Min Yuen Teo |
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| Rok vydání: | 2012 |
| Předmět: | |
| Zdroj: | Journal of Clinical Oncology. 30:e17561-e17561 |
| ISSN: | 1527-7755 0732-183X |
| Popis: | e17561 Background: Doubling time in non-SCLC tumors has been well studied, but this is less so in SCLC. We aim to study in vivo doubling time in SCLC using modern imaging techniques. Methods: Patients (pts) with SCLC with both diagnostic computed tomography (CT) and subsequent staging Positron Emission Tomography (PET)/CT were identified from institutional database. Primary lesion and nodal disease on the initial CT scan and on the CT component of PET/CT scan was measured. Diameter Doubling Time (D-DT) = [(dt)*log 2] / [3(log D2 – log D1)], where dt was time interval between scans, D2 and D1 are diameters of lesion on second and first scan respectively. Volume Doubling Time (V-DT) = [(dt)*log 2] / (log V2 – log V1), where V2 and V1 are volume of 2nd and 1st CT. Results: 18 eligible pts were identified. 61% were males, median age 63. Primary lesion was assessable in 14 pts and nodal disease in 17. Mean interval between scans was 19.7 days (range: 6 – 67). Mean diameter of primary lesion on 1st and 2nd scans: 4.17 cm +/- 2.11 and 4.63 cm +/- 2.26. Mean diameter of lymph nodes on 1st and 2nd scans: 4.24 cm +/- 1.72 and 4.78 cm +/- 1.81. Mean volume of primary lesion on 1st and 2nd scans: 35.56 cm3 (=/- 43.34) and 45.52 cm3 (+/- 55.66). Mean volume of nodal disease on 1st and 2nd scans: 32.77 cm3 (+/- 44.52) and 44.16 cm3 (+/- 55.06). For primary tumor, mean D-DT was 70.0 days +/- 16.4, with mean V-DT 60.5 days +/- 11.8, p=.64. There is a significant correlation between D-DT and V-DT with Pearson rho of 0.7691 (p=0.0013). For nodal disease, mean D-DT = 51.1 days +/- 15.1 and mean V-DT 42.2 days +/- 9.3, p= .62, with correlation between D-DT and V-DT, Pearson rho of 0.7609, p=.0004. There was higher doubling time in extensive stage (ES) SCLC primary tumors compared with limited stage (LS), with mean D-DT 24.0 days vs 97.6 days, p=.046. When all lesions analyzed collectively, mean D-DT = 59.6 days, 95% CI 37.1 – 82.2 and mean V-DT = 50.5 days, 95% CI 35.3 – 65.7. Conclusions: Our data demonstrate more rapid doubling time of SCLC compared to historical data. The differential in growth between LS and ES points to a biologic dichotomy. This has a significant impact in the timely management of SCLC, and potential avenues for therapeutic development. |
| Databáze: | OpenAIRE |
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