International journal of radiation oncology, biology, physics, 2011-02, Vol.79 (2), p.466-472
2011
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- Autor(en) / Beteiligte
- Titel
- Rapid Disease Progression With Delay in Treatment of Non–Small-Cell Lung Cancer
- Ist Teil von
- International journal of radiation oncology, biology, physics, 2011-02, Vol.79 (2), p.466-472
- Ort / Verlag
- New York, NY: Elsevier Inc
- Erscheinungsjahr
- 2011
- Quelle
- MEDLINE
- Beschreibungen/Notizen
- Purpose To assess rate of disease progression from diagnosis to initiation of treatment for Stage I-IIIB non–small-cell lung cancer (NSCLC). Methods and Materials Forty patients with NSCLC underwent at least two sets of computed tomography (CT) and 18-fluorodeoxyglucose positron emission tomography (PET) scans at various time intervals before treatment. Progression was defined as development of any new lymph node involvement, site of disease, or stage change. Results Median time interval between first and second CT scans was 13.4 weeks, and between first and second PET scans was 9.0 weeks. Median initial primary maximum tumor dimension (MTD) was 3.5 cm (0.6–8.5 cm) with a median standardized uptake value (SUV) of 13.0 (1.7–38.5). The median MTD increased by a median of 1.0 cm (mean, 1.6 cm) between scans for a median relative MTD increase of 35% (mean, 59%). Nineteen patients (48%) progressed between scans. Rate of any progression was 13%, 31%, and 46% at 4, 8, and 16 weeks, respectively. Upstaging occurred in 3%, 13%, and 21% at these intervals. Distant metastasis became evident in 3%, 13%, and 13% after 4, 8, and 16 weeks, respectively. T and N stage were associated with progression, whereas histology, grade, sex, age, and maximum SUV were not. At 3 years, overall survival for Stage III patients with vs. without progression was 18% vs. 67%, p = 0.05. Conclusions With NSCLC, treatment delay can lead to disease progression. Diagnosis, staging, and treatment initiation should be expedited. After 4–8 weeks of delay, complete restaging should be strongly considered.
- Sprache
- Englisch
- Identifikatoren
- ISSN: 0360-3016eISSN: 1879-355XDOI: 10.1016/j.ijrobp.2009.11.029Titel-ID: cdi_osti_scitechconnect_21491586
- Format
- –
- Schlagworte
- Aged, ANTIMETABOLITES, BETA DECAY RADIOISOTOPES, BETA-PLUS DECAY RADIOISOTOPES, Biological and medical sciences, BODY, Carcinoma, Non-Small-Cell Lung - diagnostic imaging, Carcinoma, Non-Small-Cell Lung - pathology, Carcinoma, Non-Small-Cell Lung - radiotherapy, CAT SCANNING, COMPUTERIZED TOMOGRAPHY, DIAGNOSTIC TECHNIQUES, Disease Progression, DISEASES, DRUGS, EMISSION COMPUTED TOMOGRAPHY, Female, FLUORINE 18, FLUORINE ISOTOPES, FLUORODEOXYGLUCOSE, Hematology, Oncology and Palliative Medicine, HOURS LIVING RADIOISOTOPES, Humans, ISOMERIC TRANSITION ISOTOPES, ISOTOPES, LIGHT NUCLEI, Lung cancer, Lung Neoplasms - diagnostic imaging, Lung Neoplasms - pathology, Lung Neoplasms - radiotherapy, LUNGS, LYMPH NODES, LYMPHATIC SYSTEM, Male, Medical sciences, Middle Aged, NANOSECONDS LIVING RADIOISOTOPES, Natural history, Neoplasm Staging, NEOPLASMS, NUCLEI, ODD-ODD NUCLEI, ORGANS, Pneumology, POSITRON COMPUTED TOMOGRAPHY, Positron-Emission Tomography - methods, Progression, RADIOISOTOPES, Radiology, RADIOLOGY AND NUCLEAR MEDICINE, RESPIRATORY SYSTEM, Survival Analysis, TOMOGRAPHY, Tomography, X-Ray Computed - methods, Treatment delay, Tumor Burden, Tumors of the respiratory system and mediastinum