Assessing Response to Treatment in Non-Small-Cell Lung Cancer: Role of Tumor Volume Evaluated By Computed Tomography

作者：Knollmann Friedrich D^*; Kumthekar Rohan; Fetzer David; Socinski Mark A

来源：Clinical Lung Cancer, 2014, 15(2): 103-109.

DOI：10.1016/j.cllc.2013.11.001

• CT
• Carcinoma
• Imaging
• Survival
• Outcome

To investigate the prognostic value of tumor volume changes, computed tomography examinations from 100 patients with advanced lung cancer were analyzed. Changes in tumor volume were not associated with overall survival. The results suggest that volumetric measurements of tumor size may not predict survival with sufficient accuracy to use it as a surrogate marker of treatment success in individual patients.
Introduction: We set out to investigate whether volumetric tumor measurements allow for a prediction of treatment response, as measured by patient survival, in patients with advanced non-small-cell lung cancer (NSCLC). Materials and Methods: Patients with nonresectable NSCLC (stage III or IV, n = 100) who were repeatedly evaluated for treatment response by computed tomography (CT) were included in a Health Insurance Portability and Accountability Act (HIPAA)-compliant retrospective study. Tumor response was measured by comparing tumor volumes over time. Patient survival was compared with Response Evaluation Criteria in Solid Tumors (RECIST) using Kaplan-Meier survival statistics and Cox regression analysis. Results: The median overall patient survival was 553 days (standard error, 146 days); for patients with stage III NSCLC, it was 822 days, and for patients with stage IV disease, 479 days. The survival differences were not statistically significant (P = .09). According to RECIST, 5 patients demonstrated complete response, 39 partial response, 44 stable disease, and 12 progressive disease. Patient survival was not significantly associated with RECIST class, the change of the sum of tumor diameters (P = .98), nor the change of the sum of volumetric tumor dimensions (P = .17). Conclusion: In a group of 100 patients with advanced-stage NSCLC, neither volumetric CT measurements of changes in tumor size nor RECIST class significantly predicted patient survival. This observation suggests that size response may not be a sufficiently precise surrogate marker of success to steer treatment decisions in individual patients.

• 出版日期2014-3