scholarly journals Feasibility of Texture Analysis–Based Dosimetry in Computed Tomography Scans During Radiation Therapy of Non-Small Cell Lung Cancer

2016 ◽  
Vol 96 (2) ◽  
pp. E629
Author(s):  
J. Chalubinska-Fendler ◽  
L. Karolczak ◽  
W. Fendler ◽  
J. Bury ◽  
M. Spych ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Radiation Therapy ◽  
Small Cell Lung Cancer ◽  
Texture Analysis ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Computed Tomography Scans

scholarly journals Tumor Response Dynamics During First-Line Pembrolizumab Therapy in Patients With Advanced Non–Small-Cell Lung Cancer

2021 ◽  
pp. 501-509
Author(s):  
Mizuki Nishino ◽  
Fangxin Hong ◽  
Biagio Ricciuti ◽  
Hiroto Hatabu ◽  
Mark M. Awad
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Tumor Burden ◽  
Small Cell ◽  
Small Cell Lung ◽  
First Line ◽  
Overall Response ◽  
Computed Tomography Scans

PURPOSE The objectives of the study were to characterize the tumor burden dynamics on serial computed tomography scans in patients with advanced non–small-cell lung cancer treated with first-line pembrolizumab and to identify imaging markers for prolonged overall survival (OS). MATERIALS AND METHODS Eighty-eight patients treated with first-line pembrolizumab monotherapy were evaluated on serial computed tomography scans to characterize their quantitative tumor burden during therapy. Tumor burden dynamics were studied for the association with OS. RESULTS The overall response rate was 42% (37/88), with the median tumor burden changes at the best overall response of −18.3% (range, −100.0% to +103.6%). Response rates were higher in men than in women ( P = .05) and in patients with higher programmed cell death ligand-1 expression levels ( P = .02). Tumor burden stayed below the baseline burden throughout therapy in 55 patients (63%). In an 8-week landmark analysis, patients with tumor burden below the baseline burden during the first 8 weeks of therapy had longer OS compared with patients who had ≥ 0% increase (median OS, 30.7 v 16.2 months; hazard ratio [HR] = 0.44; P = .01). In the extended Cox models, patients whose tumor burden stayed below the baseline burden throughout therapy had significantly reduced hazards of death (HR = 0.41, P = .003, univariate; HR = 0.35, P = .02, multivariate). Only one patient (1.1%) experienced pseudoprogression with initial tumor increase and subsequent tumor regression. CONCLUSION In patients with advanced non–small-cell lung cancer treated with first-line single-agent pembrolizumab, tumor burden reduction below the baseline burden during therapy was an independent marker for prolonged OS, which may serve as a practical guide for treatment decisions.

Survival Outcomes After Radiation Therapy for Stage III Non–Small-Cell Lung Cancer After Adoption of Computed Tomography–Based Simulation

2011 ◽  
Vol 29 (17) ◽  
pp. 2305-2311 ◽  
Author(s):  
Aileen B. Chen ◽  
Bridget A. Neville ◽  
David J. Sher ◽  
Kun Chen ◽  
Deborah Schrag
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Radiation Therapy ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Stage Iii ◽  
Small Cell Lung ◽  
Ct Simulation ◽  
The Impact

Purpose Technical studies suggest that computed tomography (CT) –based simulation improves the therapeutic ratio for thoracic radiation therapy (TRT), although few studies have evaluated its use or impact on outcomes. Methods We used the Surveillance, Epidemiology and End Results (SEER) –Medicare linked data to identify CT-based simulation for TRT among Medicare beneficiaries diagnosed with stage III non–small-cell lung cancer (NSCLC) between 2000 and 2005. Demographic and clinical factors associated with use of CT simulation were identified, and the impact of CT simulation on survival was analyzed by using Cox models and propensity score analysis. Results The proportion of patients treated with TRT who had CT simulation increased from 2.4% in 1994 to 34.0% in 2000 to 77.6% in 2005. Of the 5,540 patients treated with TRT from 2000 to 2005, 60.1% had CT simulation. Geographic variation was seen in rates of CT simulation, with lower rates in rural areas and in the South and West compared with those in the Northeast and Midwest. Patients treated with chemotherapy were more likely to have CT simulation (65.2% v 51.2%; adjusted odds ratio, 1.67; 95% CI, 1.48 to 1.88; P < .01), although there was no significant association between use of surgery and CT simulation. Controlling for demographic and clinical characteristics, CT simulation was associated with lower risk of death (adjusted hazard ratio, 0.77; 95% CI, 0.73 to 0.82; P < .01) compared with conventional simulation. Conclusion CT-based simulation has been widely, although not uniformly, adopted for the treatment of stage III NSCLC and is associated with higher survival among patients receiving TRT.

STEREOTACTIC BODY RADIATION THERAPY FOR EARLY-STAGE NON-SMALL CELL LUNG CANCER

2018 ◽  
Vol 64 (5) ◽  
pp. 638-644
Author(s):  
Andrey Arsenev ◽  
Sergey Novikov ◽  
Sergey Kanaev ◽  
Anton Barchuk ◽  
Andrey Nefedov ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Early Stage ◽  
Small Cell ◽  
Small Cell Lung ◽  
Stereotactic Radiation ◽  
Screening Programs ◽  
Surgical Methods

An active introduction of screening programs potentially leads to a significant increase in the proportion of patients with early forms of non-small cell lung cancer. Surgical treatment, which is the standard of care for localized forms, due to functional limitations can be performed only in 65-70% of patients. The solution to this problem can be found in the improvement of the results of radiotherapy by using modern equipment, the planning systems, improved fractionation schemes and introduction of methods for summing radiation doses. Stereotactic radiotherapy allows high-precision delivery of high radiation dose to tumor with a minimal damage to surrounding healthy tissues. In this literature review based on the analysis of a large number of publications we show that it is not yet possible to make valid conclusions about the effectiveness and safety of stereotactic radiation therapy as an alternative to the surgical methods. It is necessary to plan and conduct randomized trials without further delay taking into account the expected high relevance of the method.

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