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Tumour size reduction after the first chemotherapy-course and outcomes of chemoradiotherapy in limited disease small-cell lung cancer

Permanent lenke
https://hdl.handle.net/10037/12075
DOI
https://doi.org/10.1016/j.lungcan.2016.10.003
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Åpne
article.pdf (544.5Kb)
Accepted manuscript version (PDF)
Dato
2016-10-15
Type
Journal article
Tidsskriftartikkel
Peer reviewed

Forfatter
Halvorsen, Tarje Onsøien; Herje, Martin; Levin, Nina; Bremnes, Roy M.; Brustugun, Odd Terje; Fløtten, Øystein; Kaasa, Stein; Sundstrøm, Stein Harald; Grønberg, Bjørn Henning
Sammendrag
Objectives:
Concurrent chemotherapy and thoracic radiotherapy (TRT) is recommended for limited disease small-cell lung cancer (LD SCLC). TRT should start as early as possible, often meaning with the second course due to patient referral time and the fact that TRT planning takes time. Early assessment of response to the first course of chemotherapy may be a useful way to individualise treatment. The aims of this study were to assess tumour size reduction after the first chemotherapy-course, and whether this reduction was associated with outcomes in LD SCLC.
Material and methods:
A randomised trial comparing twice-daily (45 Gy/30 fractions) with once-daily (42 Gy/15 fractions) TRT, given concurrently with four courses of cisplatin/etoposide (n = 157) was the basis for this study. Tumour size was assessed on CT scans at baseline and planning scans for TRT according to RECIST 1.0.
Results:
CT scans were available for 135 patients (86%). Ninety-four percent had a reduction in tumour size after the first chemotherapy-course. The median reduction in sum of diameters (SOD) of measurable lesions was ÷16 mm (÷84 to +10 mm), corresponding to ÷18% (÷51 to +12%). Eighty-two percent had stable disease, 18% partial response. Reduction in SOD was significantly associated with complete response at first follow-up (OR: 1.05, 95% CI 1.01–1.09; p=0.013), PFS (HR: 0.97, 95% CI 0.96-0.99; p=0.001), and overall survival (HR: 0.98, 95% CI 0.96–1.00; p=0.010).
Conclusion:
Response from the first course of chemotherapy had a significant positive association with outcomes from chemoradiotherapy, and might be used to stratify and randomise patients in future studies.
Beskrivelse
Accepted manuscript version. Published version available at https://doi.org/10.1016/j.lungcan.2016.10.003
Forlag
Elsevier
Sitering
Halvorsen, T., Herje, M., Levin, N., Bremnes, R. M., Brustugun, O. T., Fløtten, Ø. (...) Grønberg BH. (2016). Tumour size reduction after the first chemotherapy-course and outcomes of chemoradiotherapy in limited disease small-cell lung cancer. Lung Cancer. 102:9-14.
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  • Artikler, rapporter og annet (klinisk medisin) [1974]

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