Local Recurrence Risk Score to Predict Relapse after Stereotactic Body Radiation Therapy for Lung Tumors
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. SBRT
2.3. FDG-PET Procedure and Parameters
2.4. CT Scan Monitoring
2.5. Local Relapse Definition
2.6. Independent Validation Cohort
3. Statistical Analysis
4. Results
4.1. Patients and SBRT Characteristics
4.2. Risk Factors for Local Recurrence and Score
4.3. Overall and Local Recurrence-Free Survival
5. Discussion
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
BED | biologic effective dose |
CT | computed tomography |
FDG-PET | fluorine-18-fluorodeoxyglucose positron emission tomography |
MTV | metabolic tumor volume |
NSCLC | non-small-cell lung cancer |
ROC | receiver operating characteristics |
SBRT | stereotactic body radiation therapy |
SUV | standardized uptake value |
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Characteristics | Train Cohort (N = 38) | Validation Cohort (N = 10) | p-Value |
---|---|---|---|
Gender | |||
Male | 28 (74%) | 4 (40%) | 0.06 |
Female | 10 (26%) | 6 (60%) | |
Age (years) | 70 ± 12 [49–90] | 66 ± 11 [55–80] | 0.34 |
Tobacco use | 25 (66%) | 10 (100%) | 0.04 |
Diabetes | 7 (18%) | 1 (10%) | 0.99 |
Cardiovascular diseases | 27 (71%) | 7 (70%) | 0.99 |
ECOG performance status | |||
0 | 17 (45%) | 2 (20%) | 0.06 |
1 | 9 (24%) | 5 (50%) | |
2 | 4 (11%) | 3 (30%) | |
3 | 0 (0%) | 0 (0%) | |
4 | 0 (0%) | 0 (0%) | |
Unknown | 8 (21%) | 0 (0%) | |
Lung tumors | |||
NSCLC | 27 (71%) | 9 (90%) | 0.22 |
Metastases | 11 (29%) | 1 (10%) | |
Tumor location | |||
Central tumor | 11 (29%) | 3 (30%) | 0.95 |
Peripheral tumor | 27 (71%) | 7 (70%) | |
Lobe | |||
Superior lobe | 20 (53%) | 3 (30%) | 0.03 |
Middle lobe or lingula | 8 (21%) | 0 (0%) | |
Inferior lobe | 10 (26%) | 7 (70%) | |
Histological biopsy proof of malignancy | 11 (29%) | 8 (80%) | |
Adenocarcinoma | 6 (16%) | 8 (80%) | 0.08 |
Squamous cell carcinoma | 4 (11%) | 0 (0%) | |
Renal adenocarcinoma metastasis | 1 (3%) | 0 (0%) | |
Previous thoracic radiotherapy | 4 (11%) | 2 (20%) | 0.42 |
Local recurrence | 13 (34%) | 2 (20%) | 0.39 |
Reason of not surgery treatment | |||
Surgical contraindication | 27 (71%) | 10 (100%) | 0.15 |
- Respiratory insufficiency | 17 (37%) | 6 (60%) | |
- Others | 10 (26%) | 4 (40%) | |
Patient refusal | 2 (5%) | 0 (0%) | |
Unknown | 9 (24%) | 0 (0%) |
Variables | Odds Ratio | 95% CI | p-Value | Risk Score Calculation | |
---|---|---|---|---|---|
Sequentially enlarging mass-like lesion | 12.0 | 1.2–120.1 | 0.034 | Yes | 1 |
No | 0 | ||||
Craniocaudal growth | 19.2 | 1.8–199.9 | 0.013 | Yes | 1 |
No | 0 | ||||
Bulging margin | 10.6 | 1.5–76.1 | 0.019 | Yes | 1 |
No | 0 | ||||
SUVmax ≥ 5.5 | 11.0 | 1.6–73.9 | 0.014 | Yes | 1 |
No | 0 | ||||
Gender (Female) | 11.0 | 1.6–73.9 | 0.014 | Yes | 1 |
No | 0 | ||||
Total: …/5 |
Patients | Scores | Defined by the Score: Local Relapse Yes/No | Real Outcomes | ||
---|---|---|---|---|---|
1 | 0 | No | No relapse | ||
2 | 1 | No | No relapse | ||
3 | 3 | Yes | Local relapse (biopsy-proven) | ||
4 | 0 | No | No relapse | ||
5 | 2 | No | No relapse | ||
6 | 1 | No | No relapse | ||
7 | 5 | Yes | No relapse | ||
8 | 3 | Yes | Local relapse (biopsy-proven) | ||
9 | 0 | No | No relapse | ||
10 | 1 | No | No relapse | ||
True relapse | No relapse | ||||
Predicted relapse | 2 | 1 | |||
Predicted no relapse | 0 | 7 |
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Pougnet, I.; Habert, P.; Delcourt, S.; Boucekine, M.; Wong, S.; Zacchariotto, A.; Muracciole, X.; Gaubert, J.-Y.; Padovani, L. Local Recurrence Risk Score to Predict Relapse after Stereotactic Body Radiation Therapy for Lung Tumors. J. Clin. Med. 2022, 11, 6445. https://doi.org/10.3390/jcm11216445
Pougnet I, Habert P, Delcourt S, Boucekine M, Wong S, Zacchariotto A, Muracciole X, Gaubert J-Y, Padovani L. Local Recurrence Risk Score to Predict Relapse after Stereotactic Body Radiation Therapy for Lung Tumors. Journal of Clinical Medicine. 2022; 11(21):6445. https://doi.org/10.3390/jcm11216445
Chicago/Turabian StylePougnet, Isabelle, Paul Habert, Sarkis Delcourt, Mohamed Boucekine, Stephanie Wong, Audrey Zacchariotto, Xavier Muracciole, Jean-Yves Gaubert, and Laetitia Padovani. 2022. "Local Recurrence Risk Score to Predict Relapse after Stereotactic Body Radiation Therapy for Lung Tumors" Journal of Clinical Medicine 11, no. 21: 6445. https://doi.org/10.3390/jcm11216445
APA StylePougnet, I., Habert, P., Delcourt, S., Boucekine, M., Wong, S., Zacchariotto, A., Muracciole, X., Gaubert, J. -Y., & Padovani, L. (2022). Local Recurrence Risk Score to Predict Relapse after Stereotactic Body Radiation Therapy for Lung Tumors. Journal of Clinical Medicine, 11(21), 6445. https://doi.org/10.3390/jcm11216445