BACKGROUND AND PURPOSE: To determine the effect of tumor volume and dose factors derived from 3-D treatment planning dose distributions on survival outcome for non-small cell lung cancer patients. MATERIALS AND METHODS: Seventy-six consecutive patients diagnosed with medically inoperable or locally advanced, unresectable non-small cell lung cancer planned with 3-D treatment planning between 1986 and 1992 were the subject of this retrospective study. Patient characteristics and dosimetric parameters were analyzed for influence on overall survival and local progression-free survival (LPFS) using univariate and multivariate analysis. RESULTS: Nodal stage and stage were the most significant factors for overall survival and LPFS duration on both univariate and multivariate analysis. We found a wide range of primary tumor volume sizes for each stage. Patients with tumor volumes <200 cm3 had longer survival (P = 0.047). In an analysis stratifying patients into four groups by tumor volume (<200 cm3 versus >200 cm3) and nodes (negative versus positive), patients in the group with no nodal disease and <200 cm3 tumor volumes survived longer than patients in any other group (P = 0.046). No dose factors were statistically significant for longer survival. Longer LPFS was seen for (a) isocenter dose >70 Gy (P = 0.055) for the overall group of patients, (b) within a subgroup with no nodal disease and >73 Gy (P = 0.054), and (c) within a subgroup with no nodal disease and tumor volume <200 cm3 receiving >73 Gy (P = 0.086). CONCLUSIONS: Several findings from the volume and dosimetric analysis in this study are noteworthy. Stage was found to be a poor predictor of primary tumor volume size. Also, tumor volume size (<200 cm3) in conjunction with nodal status (negative nodes) had an impact on survival though there was a mix of stage (I, IIIa, IIIb) in this group of patients. Finally, dose appears to influence local control (LPFS) for the overall group of patients and when tumor volumes are <200 cm3. Our data indicate that outcome following radiation may be better predicted by a staging system that takes into account tumor volume and nodal spread rather than a system that is largely based on anatomic location of disease. Dose prescription for lung cancer treatment might better be written based on tumor volume size.
BACKGROUND AND PURPOSE: To determine the effect of tumor volume and dose factors derived from 3-D treatment planning dose distributions on survival outcome for non-small cell lung cancerpatients. MATERIALS AND METHODS: Seventy-six consecutive patients diagnosed with medically inoperable or locally advanced, unresectable non-small cell lung cancer planned with 3-D treatment planning between 1986 and 1992 were the subject of this retrospective study. Patient characteristics and dosimetric parameters were analyzed for influence on overall survival and local progression-free survival (LPFS) using univariate and multivariate analysis. RESULTS: Nodal stage and stage were the most significant factors for overall survival and LPFS duration on both univariate and multivariate analysis. We found a wide range of primary tumor volume sizes for each stage. Patients with tumor volumes <200 cm3 had longer survival (P = 0.047). In an analysis stratifying patients into four groups by tumor volume (<200 cm3 versus >200 cm3) and nodes (negative versus positive), patients in the group with no nodal disease and <200 cm3 tumor volumes survived longer than patients in any other group (P = 0.046). No dose factors were statistically significant for longer survival. Longer LPFS was seen for (a) isocenter dose >70 Gy (P = 0.055) for the overall group of patients, (b) within a subgroup with no nodal disease and >73 Gy (P = 0.054), and (c) within a subgroup with no nodal disease and tumor volume <200 cm3 receiving >73 Gy (P = 0.086). CONCLUSIONS: Several findings from the volume and dosimetric analysis in this study are noteworthy. Stage was found to be a poor predictor of primary tumor volume size. Also, tumor volume size (<200 cm3) in conjunction with nodal status (negative nodes) had an impact on survival though there was a mix of stage (I, IIIa, IIIb) in this group of patients. Finally, dose appears to influence local control (LPFS) for the overall group of patients and when tumor volumes are <200 cm3. Our data indicate that outcome following radiation may be better predicted by a staging system that takes into account tumor volume and nodal spread rather than a system that is largely based on anatomic location of disease. Dose prescription for lung cancer treatment might better be written based on tumor volume size.
Authors: Lukas Käsmann; Maximilian Niyazi; Oliver Blanck; Christian Baues; René Baumann; Sophie Dobiasch; Chukwuka Eze; Daniel Fleischmann; Tobias Gauer; Frank A Giordano; Yvonne Goy; Jan Hausmann; Christoph Henkenberens; David Kaul; Lisa Klook; David Krug; Matthias Mäurer; Cédric M Panje; Johannes Rosenbrock; Lisa Sautter; Daniela Schmitt; Christoph Süß; Alexander H Thieme; Maike Trommer-Nestler; Sonia Ziegler; Nadja Ebert; Daniel Medenwald; Christian Ostheimer Journal: Strahlenther Onkol Date: 2017-10-13 Impact factor: 3.621
Authors: Thomas E Stinchcombe; Lydia Hodgson; James E Herndon; Michael J Kelley; M Giulia Cicchetti; Nithya Ramnath; Harvey B Niell; James N Atkins; Wallace Akerley; Mark R Green; Everett E Vokes Journal: J Thorac Oncol Date: 2009-09 Impact factor: 15.609
Authors: Feng-Ming Kong; Randall K Ten Haken; Matthew Schipper; Kirk A Frey; James Hayman; Milton Gross; Nithya Ramnath; Khaled A Hassan; Martha Matuszak; Timothy Ritter; Nan Bi; Weili Wang; Mark Orringer; Kemp B Cease; Theodore S Lawrence; Gregory P Kalemkerian Journal: JAMA Oncol Date: 2017-10-01 Impact factor: 31.777