Pre-treatment CT imaging in stage IIIA lung cancer: Can we predict local recurrence after definitive chemoradiotherapy? Journal Article


Authors: Plodkowski, A. J.; Araujo-Filho, J. A. B.; Simmers, C. D. A.; Girshman, J.; Raj, M.; Zheng, J.; Rimner, A.; Ginsberg, M. S.
Article Title: Pre-treatment CT imaging in stage IIIA lung cancer: Can we predict local recurrence after definitive chemoradiotherapy?
Abstract: Objectives: The aim of this study was to delineate computed tomography (CT) features of stage IIIA non-small cell lung cancers on pre-treatment staging studies and identify features that could predict local recurrence after definitive concurrent chemoradiotherapy. Materials and methods: We retrospectively reviewed pre- and post-treatment CT scans for 91 patients with Stage IIIA non-small cell lung cancer undergoing definitive concurrent chemoradiotherapy. Pre-treatment CT qualitative features were evaluated by consensus. The primary endpoint was local recurrence as determined on post-treatment CT scans along with the radiotherapy fields. Local recurrence was defined as intrathoracic in-field and marginal as opposed to out-of-field failures. Competing risk regressions were used to examine associations between CT features and recurrence. Results: The median follow-up was 51.5 months (range 2.4–111.2). Median overall survival was 25.6 months (95% CI: 20.4–30). At last follow-up, 72 (79.1%) patients had died, 48 (52.7%) had in-field recurrence, and 30 (32.9%) presented with out-of-field recurrence. On pre-treatment CT scans, tumors presenting as pulmonary consolidations (hazard ratio = 2.34, 95% CI: 1.05–5.22; p 0.038) were more likely to have in-field failure. Tumors with 50–100% necrosis (hazard ratio = 0.15, 95% CI: 0.02–1.06) were associated with decreased out-of-field failure (overall p = 0.038). However, these were rare features in our sample which limit the ability of these features to be associated with such outcomes. Conclusions: Pre-treatment CT features alone are limited in predicting locoregional recurrence. Larger studies using quantitative tools are needed to predict such outcomes. © 2020 Elsevier Inc.
Keywords: overall survival; staging; cell death; lung cancer; recurrence; computerized tomography; tumors; forecasting; biological organs; ct; diseases; chemoradiotherapy; non small cell lung cancer; local recurrence; in-field recurrence; hazards; concurrent chemoradiotherapy; locoregional recurrence; quantitative tool; stage iiia; qualitative features
Journal Title: Clinical Imaging
Volume: 69
ISSN: 0899-7071
Publisher: Elsevier Inc.  
Date Published: 2021-01-01
Start Page: 133
End Page: 138
Language: English
DOI: 10.1016/j.clinimag.2020.07.005
PROVIDER: scopus
PUBMED: 32721848
DOI/URL:
Notes: Article -- Export Date: 3 August 2020 -- Source: Scopus
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MSK Authors
  1. Junting Zheng
    156 Zheng
  2. Michelle S Ginsberg
    179 Ginsberg
  3. Andreas Rimner
    324 Rimner
  4. Micheal Raj
    6 Raj