Incidence of High-Risk Radiologic Features in Patients Without Local Recurrence After Stereotactic Ablative Radiation Therapy for Early-Stage Non-Small Cell Lung Cancer
| Autor: | David A. Palma, Eva M. Bongers, Andrew Warner, Suresh Senan, C.J.A. Haasbeek, J.R. van Sornsen de Koste, Merle I. Ronden, Berend J. Slotman, Gerrit J. Blom, Aaron D. Ward, Carol Johnson, Femke O.B. Spoelstra |
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| Přispěvatelé: | Pulmonary medicine, APH - Quality of Care, APH - Personalized Medicine, Radiation Oncology, CCA - Imaging and biomarkers |
| Rok vydání: | 2018 |
| Předmět: |
Cancer Research
Lung Neoplasms Pulmonary Fibrosis medicine.medical_treatment Radiosurgery SABR volatility model 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Carcinoma Non-Small-Cell Lung Biopsy medicine Carcinoma Humans Radiology Nuclear Medicine and imaging Stage (cooking) Lung cancer Radiation medicine.diagnostic_test business.industry Incidence (epidemiology) medicine.disease Radiation therapy Oncology 030220 oncology & carcinogenesis Tomography Neoplasm Recurrence Local Tomography X-Ray Computed Nuclear medicine business |
| Zdroj: | International Journal of Radiation Oncology Biology Physics, 100(1), 115-121. Elsevier Inc. Ronden, M I, van Sörnsen de Koste, J R, Johnson, C, Slotman, B J, Spoelstra, F O B, Haasbeek, C J A, Blom, G, Bongers, E M, Warner, A, Ward, A, Palma, D & Senan, S 2018, ' Incidence of High-Risk Radiologic Features in Patients Without Local Recurrence After Stereotactic Ablative Radiation Therapy for Early-Stage Non-Small Cell Lung Cancer ', International Journal of Radiation Oncology Biology Physics, vol. 100, no. 1, pp. 115-121 . https://doi.org/10.1016/j.ijrobp.2017.09.035 |
| ISSN: | 0360-3016 |
| Popis: | PURPOSE: To investigate, in the setting of stereotactic ablative radiation therapy (SABR) for early-stage non-small cell lung cancer, the incidence and patterns of change in high-risk radiologic features (HRFs) in patients known to have no local recurrence.METHODS AND MATERIALS: Computed tomography (CT) scans of patients treated using volumetric modulated arc therapy SABR between 2008 and 2013 were eligible if follow-up scans were available for 2 years and no local recurrences were diagnosed. All scans were reviewed at a workstation using an add-on tool for ClearCanvas (Synaptive Medical). Five clinicians who were blinded to clinical outcomes scored the presence of HRFs: enlarging opacity (EO), sequential enlarging opacity, enlarging opacity after 12 months (EO12), bulging margin, loss of linear margins, cranio-caudal growth, and loss of air bronchogram. After each review, clinicians recommended follow-up procedures based on published recommendations.RESULTS: A total of 88 patients (747 CT scans) were evaluated. The HRFs most frequently recorded by ≥3 observers on at least 1 follow-up scan were EO (64.8%), EO12 (50.0%), and sequential enlarging opacity (13.6%). Fifty-six patients developed EO within the first year after SABR, and of these, 46 also developed subsequent EO (EO12). In 76 patients who developed EO after 1 year of follow-up, 30 had not manifested EO previously. Three or more HRFs have been associated with recurrences, and this was observed on CT scan in 22.7% of patients. In their routine care, 6 patients had undergone a positron emission tomography scan because of a suspected local recurrence, and 4 underwent an attempt at biopsy.CONCLUSIONS: More than 50% of patients without a local recurrence after SABR develop HRFs. Because ≥3 HRFs were present in nearly 25% of patients, further refinement of follow-up recommendations are necessary. |
| Databáze: | OpenAIRE |
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