Predictive and prognostic value of tumor volume and its changes during radical radiotherapy of
			stage III non-small cell lung cancer

Käsmann, Lukas; Niyazi, Maximilian; Blanck, Oliver; Baues, Christian; Baumann, René; Dobiasch, Sophie; Eze, Chukwuka; Fleischmann, Daniel; Gauer, Tobias; Giordano, Frank A.; Goy, Y.; Hausmann, J. Niklas; Henkenberens, Christoph; Kaul, David; Klook, Lisa; Krug, David; Mäurer, Matthias; Panje, Cédric; Rosenbrock, Johannes; Sautter, Lisa; Schmitt, Daniela; Süß, Christoph; Thieme, Alexander; Trommer-Nestler, Maike; Ziegler, Sonia; Ebert, Nadja; Medenwald, Daniel; Ostheimer, C.

doi:10.1007/s00066-017-1221-y

Cited by 33 publications

(32 citation statements)

References 44 publications

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“…In this light, further studies are warranted to determine the possible role of immunotherapy in treatment of early NSCLC with underlying pulmonary diseases receiving radiotherapy. Another area of particular interest in the field of radiotherapy is image-guided radiotherapy 36,37. Considering its greater capacity of sparing functioning lung tissues or less-irritating sensitive lung tissue compared to conventional radiotherapy technique, image-guided radiotherapy may be a potential option for patients with NSCLC with pulmonary diseases.…”

Section: Discussionmentioning

confidence: 99%

<p>Impact Of Underlying Pulmonary Diseases On Treatment Outcomes In Early-Stage Non-Small Cell Lung Cancer Treated With Definitive Radiotherapy</p>

Kim

Yoo

Pyo

et al. 2019

COPD

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PurposeCurrent guidelines recommend definitive radiotherapy for patients with medically inoperable early-stage non-small cell lung cancer (NSCLC). However, the impact of underlying pulmonary diseases on survival in those patients remains unclear.MethodsWe retrospectively reviewed the medical records of 234 patients with stage I-II NSCLC treated with definitive radiotherapy alone at Samsung Medical Center between January 2010 and October 2017. We compared survival outcomes according to the presence of underlying pulmonary diseases, including chronic obstructive pulmonary disease (COPD), combined pulmonary fibrosis and emphysema (CPFE), and idiopathic pulmonary fibrosis (IPF). The control group in this study was stage I-II NSCLC patients who were non-COPD, non-CPFE, and non-IPF.ResultsThe median follow-up duration was 17 (range, 1–92) months. The median survival times of the control, COPD, CPFE, and IPF groups were 32, 49, 17, and 12 months, respectively (P<0.001). In a Cox proportional hazards analysis for factors associated with overall survival, patients with COPD showed a similar risk of death (adjusted hazard ratio [HR], 1.306; 95% confidence interval [CI], 0.723–2.358; P=0.376) compared to that of the control group, while patients with CPFE (adjusted HR, 3.382; 95% CI, 1.472–7.769; P=0.004) and IPF (adjusted HR, 4.061; 95% CI, 1.963–8.403; P<0.001) showed an increased risk of death.ConclusionDefinitive radiotherapy may be a tolerable treatment for early-stage NSCLC with COPD. However, poor survival in early-stage NSCLC patients with IPF or CPFE requires further study to identify and develop patient selection criteria as well as an optimal radiotherapy modality.

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Section: Discussionmentioning

confidence: 99%

<p>Impact Of Underlying Pulmonary Diseases On Treatment Outcomes In Early-Stage Non-Small Cell Lung Cancer Treated With Definitive Radiotherapy</p>

Kim

Yoo

Pyo

et al. 2019

COPD

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“…It is critical to recommend radiotherapy to the right population to maximize patient benefits. Studies have investigated the relationship between the size of lung cancer masses or tumor shrinkage rate during radiotherapy and patient prognosis 34 , 35 to identify the characteristics of the target patient population for radiotherapy. Moreover, emerging immunotherapy methods have brought new hope for lung cancer treatment.…”

Section: Discussionmentioning

confidence: 99%

Impact of chemotherapy in the prognosis of non-small-cell lung cancer patients with severe to very severe COPD

Dong

2018

COPD

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BackgroundThe aim of the study was to investigate if first-line chemotherapy improves total survival time in non-small-cell lung cancer (NSCLC) patients complicated with severe to very severe COPD.Materials and methodsThis retrospective observational clinical study included 267 consecutive NSCLC patients with COPD complications at the Department of Respiratory and Critical Care Medicine of Tianjin Chest Hospital between January 2009 and January 2018. Sixty-nine evaluable patients were included. The clinical characteristics, toxicity profile, objective response rate, and prognosis were analyzed and compared between patients receiving and those not receiving chemotherapy.ResultsForty-five and 24 patients received first-line chemotherapy plus supportive care and supportive care alone, respectively. Kaplan–Meier curves showed that patients receiving chemotherapy had a statistically significant 6-month longer median overall survival (OS) than that of patients receiving supportive care alone (14.0, 95% CI: 8.5–19.5 vs 8.0, 95% CI: 6.4–9.6, respectively) (chi2=8.857, P=0.003). In the multivariate Cox proportional hazard model adjusted for the most relevant variables, the adjusted hazard ratio (HRadj) differed significantly for the receipt of chemotherapy (HRadj=0.4464, 95% CI: 0.2495–0.7988; P=0.0066) but not for gender (HRadj=0.8527, 95% CI: 0.4461–1.6298; P=0.6297), age (HRadj=1.0021, 95% CI: 0.9609–1.0451; P=0.9214), histology (HRadj=1.4422, 95% CI: 0.6959–2.9889; P=0.3247), cancer stage (HRadj=1.9098, 95% CI: 0.8607–4.2375; P=0.1116), performance status score (HRadj=1.5155, 95% CI: 0.7523–3.0529; P=0.2446), lung function (HRadj=1.3856, 95% CI: 0.7149–2.6857; P=0.3341), or respiratory symptoms (HRadj=1.0518, 95% CI: 0.6032–1.8342; P=0.8586). Patients with grade 3/4 adverse reactions accounted for 29% (13/45) of the chemotherapy group.ConclusionThe results indicated that chemotherapy may improve the OS of NSCLC patients with severe to very severe COPD.

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“…Lung cancer remains the leading cause of cancer-related mortality worldwide [1–3]. Locally-advanced non-small cell lung cancer (LA-NSCLC) represents as a heterogeneous disease including large tumor volume, extensive lymph node involvement, tumor-related atelectasis and infiltration of the thoracic wall, mediastinum and spine [4–6].…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of PD-L1 expression on tumor cells combined with CD8+ TIL density in patients with locally advanced non-small cell lung cancer treated with concurrent chemoradiotherapy

et al. 2020

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Background/aimmmune checkpoint inhibition (CPI) has an increasing impact in the multimodal treatment of locally advanced non-small cell lung cancer (LA-NSCLC). Increasing evidence suggests treatment outcome depending on tumor cell PD-L1 expression. The purpose of this retrospective study was to investigate the prognostic value of PD-L1 expression on tumor cells in combination with CD8+ tumor stroma-infiltrating lymphocyte (TIL) density in inoperable LA-NSCLC treated with concurrent chemoradiotherapy (CRT).Patients and methodWe retrospectively assessed clinical characteristics and initial tumor biopsy samples of 31 inoperable LA-NSCLC patients treated with concurrent CRT. Prognostic impact of tumor cell PD-L1 expression (0% versus ≥1%) and CD8+ TIL density (0–40% vs. 41–100%) for local control, progression-free (PFS) and overall survival (OS) as well as correlations with clinicopathological features were evaluated.ResultsMedian OS was 14 months (range: 3–167 months). The OS rates at 1- and 2 years were 68 and 20%. Local control of the entire cohort at 1 and 2 years were 74 and 61%. Median PFS, 1-year and 2-year PFS were 13 ± 1.4 months, 58 and 19%. PD-L1 expression < 1% on tumor cells was associated with improved OS, PFS and local control in patients treated with concurrent CRT. Univariate analysis showed a trend towards improved OS and local control in patients with low CD8+ TIL density. Evaluation of Tumor Immunity in the MicroEnvironment (TIME) appears to be an independent prognostic factor for local control, PFS and OS. The longest and shortest OS were achieved in patients with type I (PD-L1neg/CD8low) and type IV (PD-L1pos/CD8low) tumors (median OS: 57 ± 37 vs. 10 ± 5 months, p = 0.05), respectively.ConclusionAssessment of PD-L1 expression on tumor cells in combination with CD8+ TIL density can be a predictive biomarker in patients with inoperable LA-NSCLC treated with concurrent CRT.

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Predictive and prognostic value of tumor volume and its changes during radical radiotherapy of stage III non-small cell lung cancer

Cited by 33 publications

References 44 publications

<p>Impact Of Underlying Pulmonary Diseases On Treatment Outcomes In Early-Stage Non-Small Cell Lung Cancer Treated With Definitive Radiotherapy</p>

<p>Impact Of Underlying Pulmonary Diseases On Treatment Outcomes In Early-Stage Non-Small Cell Lung Cancer Treated With Definitive Radiotherapy</p>

Impact of chemotherapy in the prognosis of non-small-cell lung cancer patients with severe to very severe COPD

Prognostic value of PD-L1 expression on tumor cells combined with CD8+ TIL density in patients with locally advanced non-small cell lung cancer treated with concurrent chemoradiotherapy

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