The complex relationship between lung tumor volume and survival in patients with non-small cell lung cancer treated by definitive radiotherapy: A prospective, observational prognostic factor study of the Trans-Tasman Radiation Oncology Group (TROG 99.05)

Ball, David L., Fisher, Richard J., Burmeister, Bryan H., Poulsen, Michael G., Graham, Peter H., Penniment, Michael G., Vinod, Shalini K., Krawitz, Hedley E., Joseph, David J., Wheeler, Greg C. and McClure, Bev E. (2013) The complex relationship between lung tumor volume and survival in patients with non-small cell lung cancer treated by definitive radiotherapy: A prospective, observational prognostic factor study of the Trans-Tasman Radiation Oncology Group (TROG 99.05). Radiotherapy and Oncology, 106 3: 305-311. doi:10.1016/j.radonc.2012.12.003


Author Ball, David L.
Fisher, Richard J.
Burmeister, Bryan H.
Poulsen, Michael G.
Graham, Peter H.
Penniment, Michael G.
Vinod, Shalini K.
Krawitz, Hedley E.
Joseph, David J.
Wheeler, Greg C.
McClure, Bev E.
Title The complex relationship between lung tumor volume and survival in patients with non-small cell lung cancer treated by definitive radiotherapy: A prospective, observational prognostic factor study of the Trans-Tasman Radiation Oncology Group (TROG 99.05)
Journal name Radiotherapy and Oncology   Check publisher's open access policy
ISSN 0167-8140
1879-0887
Publication date 2013-03
Year available 2013
Sub-type Article (original research)
DOI 10.1016/j.radonc.2012.12.003
Volume 106
Issue 3
Start page 305
End page 311
Total pages 7
Place of publication E. Park, Shannon, Clare Ireland
Publisher Elsevier Ireland Ltd
Collection year 2014
Language eng
Formatted abstract
Background and purpose: To investigate the hypothesis that primary tumor volume is prognostic independent of T and N stages in patients with non-small cell lung cancer (NSCLC) treated by definitive radiotherapy.

Materials and methods: Multicenter prospective observational study. Patient eligibility: pathologically proven stage I-III non-small cell lung cancer planned for definitive radiotherapy (minimum 50 Gy in 20 fractions) using CT-based contouring. Volumes of the primary tumor and enlarged nodes were measured according to a standardized protocol. Survival was adjusted for the effect of T and N stage.

Results: There were 509 eligible patients. Five-year survival rates for tumor volume grouped by quartiles were, for increasing tumor volume, 22%, 14%, 15% and 21%. Larger primary tumor volume was associated with shorter survival (HR = 1.060 (per doubling); 95% CI 1.01-1.12; P = 0.029). However, after adjusting for the effects of T and N stage, there was no evidence for an association (HR = 1.029, 95% CI, 0.96-1.10, P = 0.39). There was evidence, however, that larger primary tumor volume was associated with an increased risk of dying, independently of T and N stage, in the first 18 months but not beyond.

Conclusions: In patients treated by non-surgical means we were unable to show that lung tumor volume, overall, provides additional prognostic information beyond the T and N stage (TNM, 6th edition). There is evidence, however, that larger primary tumor volume adversely affects outcome only within the first 18 months. Larger tumor size alone should not by itself exclude patients from curative (chemo)radiotherapy
Keyword Tumor volume
Survival
Radiotherapy
Non small cell lung cancer
Stage
Therapy
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Medicine Publications
 
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