Abstract:
INTRODUCTION/BACKGROUND:The aim of this study was to identify imaging-based predictors of progression in patients treated with SABR for stage I NSCLC. PATIENTS AND METHODS:Between March 2003 and December 2012, 117 patients with stage I NSCLC meeting our study criteria were treated with SABR at Stanford University. Median follow-up was 17 months (range, 3-74 months) for all patients and 19 months for living patients (range, 3-74 months). Tumors were classified according to whether or not they contacted the pleura adjacent to the chest wall or mediastinum (MP), according to their maximum dimension based on computed tomography scans, and, for 102 patients who had archived pretreatment fluorine-18 fluorodeoxyglucose positron-emission tomography scans, according to SUVmax. RESULTS:Ten patients (9%) developed local progression, 17 (15%) developed regional progression, and 19 (16%) developed distant metastasis. Two-year freedom from local progression, freedom from regional progression, and freedom from distant metastasis (FFDM) were 88%, 83%, and 83%, respectively. Overall survival was 70% at 2 years. FFDM was significantly associated with MP contact, maximum tumor dimension, and SUVmax, and these variables could be combined into an exploratory prognostic index that identified patients at highest risk for developing metastases. CONCLUSION:In our cohort, noninvasive, imaging-based features were associated with distant progression after SABR for early stage NSCLC. If validated, our prognostic index could allow identification of patients who might benefit from systemic therapy after SABR.
journal_name
Clin Lung Cancerjournal_title
Clinical lung cancerauthors
Shultz DB,Trakul N,Abelson JA,Murphy JD,Maxim PG,Le QT,Loo BW Jr,Diehn Mdoi
10.1016/j.cllc.2013.12.011subject
Has Abstractpub_date
2014-07-01 00:00:00pages
294-301.e3issue
4eissn
1525-7304issn
1938-0690pii
S1525-7304(14)00023-0journal_volume
15pub_type
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