scholarly journals Tumor volume as a prognostic factor for local control and overall survival in advanced larynx cancer

2015 ◽  
Vol 126 (2) ◽  
pp. E60-E67 ◽  
Author(s):  
Adriana J. Timmermans ◽  
Charlotte A. H. Lange ◽  
Josien A. de Bois ◽  
Erik van Werkhoven ◽  
Olga Hamming-Vrieze ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factor ◽  
Local Control ◽  
Tumor Volume ◽  
Larynx Cancer

Association of tumor volume and outcomes in T3 larynx cancer with organ preservation approach.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18044-e18044
Author(s):  
Nauman Malik ◽  
Nicolin Hainc ◽  
Gia Gill ◽  
Steven Nakoneshny ◽  
Paul Kerr ◽  
...  
Keyword(s):  
Overall Survival ◽  
Cohort Study ◽  
Local Control ◽  
Systemic Therapy ◽  
Retrospective Cohort Study ◽  
Organ Preservation ◽  
Retrospective Cohort ◽  
Tumor Volume ◽  
Local Failure ◽  
Larynx Cancer

e18044 Background: Organ preservation approaches to treatment of locally advanced larynx cancers are widely used and consist of radiotherapy (RT) with or without concurrent systemic therapy (CRT). Analyses of the National Cancer Database point to decreasing survival as CRT became widely adopted in place of total laryngectomy (TL). Tumor volume in T3 laryngeal tumors has been postulated as one variable to explain this finding, with higher volume associated with lower local control based on small sample size studies largely in pre-intensity modulated radiotherapy (IMRT) era, and low volume T3 tumors being associated with improved local control with CRT. We sought to validate these findings in a contemporary cohort of T3 larynx patients treated with IMRT. Methods: This was a national, multicentre retrospective cohort study of patients diagnosed with American Joint Committee on Cancer (AJCC) T3 N0-3 M0 glottic and supraglottic cancers who underwent curative intent IMRT with or without systemic treatment from 2002-2018. Tumor volumes were calculated using a validated standardized approach by a Neuroradiologist. Primary predictor was tumor volume, primary outcome was local control (LC), and secondary outcomes included overall survival (OS), as well as late grade 3+ toxicities. Kaplan Meier estimates and log-rank tests were used for survival analyses, with Cox proportional hazards used for univariable analyses. Results: 246 patients met inclusion criteria, 147 glottic and 99 supraglottic cancers. At baseline, glottic patients were more likely to be male (p < 0.01), have a fixed vocal cord (p < 0.01), not have pre-epiglottic space invasion ( < 0.01), be cN0 (p < 0.01), and have lower grade tumors (p < 0.01). Mean tumor volumes for glottic and supraglottic tumors were 5.0 (4.2-5.8) cc and 13.0 (10.3–15.6) cc respectively. Univariable analysis showed systemic therapy was associated with improved local failure (HR 0.49, 95%CI 0.24 – 0.99, p = 0.05). Within the glottic cohort, tumor volume was not associated with local failure (HR 1.09, 95%CI 0.71 – 1.67, p = 0.38), however having a local failure event was associated with increased feeding tube dependence (HR 2.52, 95%CI 1.05 – 6.02, p = 0.04). Median local failure free survival in the overall cohort was 28.5 months, with median OS 23.2 months. There was a trend towards improved local control in the supraglottic cohort compared to glottic patients (log-rank p = 0.08), but the supraglottic cohort had significantly worse overall survival (log-rank p = 0.02). Conclusions: In this retrospective cohort study, there were baseline and outcome differences between patients with T3 glottic and supraglottic larynx cancer, with worse overall survival in supraglottic patients. Tumor volume was not associated with local control in the glottic cohort. These findings are pending further validation in a larger cohort and will be analyzed separately for supraglottic tumors.

scholarly journals Tumor volume shrinkage during stereotactic body radiotherapy is related to better prognoses in patients with stage I non-small-cell lung cancer

2020 ◽  
Vol 61 (5) ◽  
pp. 740-746
Author(s):  
Nam Vu ◽  
Hiroshi Onishi ◽  
Masahide Saito ◽  
Kengo Kuriyama ◽  
Takafumi Komiyama ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Small Cell Lung Cancer ◽  
Local Control ◽  
Cell Lung Cancer ◽  
Tumor Volume ◽  
Small Cell ◽  
Stage I ◽  
Small Cell Lung ◽  
Volume Changes

Abstract The purpose of the study was to investigate the association between tumor volume changes during stereotactic body radiation therapy (SBRT) and prognoses in stage I non-small-cell lung cancer (NSCLC). This retrospective review included stage I NSCLC patients in whom SBRT was performed at a total dose of 48.0–50.5 Gy in four or five fractions. The tumor volumes observed on computed tomography (CT) simulation and on the CT performed at the last treatment session using a CT-on-rails system were measured and compared. Then, the tumor volume changes during the SBRT period were measured and assessed for their association with prognoses (overall survival, local control, lymph node metastases and distant metastases). A total of 98 patients with a mean age of 78.6 years were enrolled in the study. The T-stage was T1a in 42%, T1b in 32% and T2a in 26% of the cases. The gross tumor volume (GTV) shrank and increased ≥10% in 23 (23.5%) and 36 (36.7%) of the cases, respectively. The 5-year local control and overall survival rates in the groups with a tumor shrinkage of ≥10% vs the group with a shrinkage of &lt;10% were 94.7 vs 70.8% and 85.4 vs 47.6%, respectively; these differences were significant, with a P-value &lt; 0.05. During a short SBRT period, the tumor shrank or enlarged in a small number of cases. A decrease of ≥10% in the GTV during SBRT was significantly related to better overall survival and local control.

scholarly journals Gamma Knife radiosurgery for brain metastasis: review of 103 patients

2009 ◽  
Vol 28 (04) ◽  
pp. 133-138
Author(s):  
Marcos Antônio Dellaretti Filho ◽  
George de Albuquerque Cavalcanti Mendes ◽  
Nicolas Reyns ◽  
Gustavo Touzet ◽  
François Dubois ◽  
...  
Keyword(s):  
Overall Survival ◽  
Brain Metastasis ◽  
Gamma Knife ◽  
Local Control ◽  
Tumor Volume ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Gamma Knife Radiosurgery ◽  
Intracranial Metastasis ◽  
Free Survival

Abstract Objective: To assess clinical and imaging outcomes in patients treated with Gamma Knife stereotactic radiosurgery (SRS) for brain metastasis. Methods: One hundred and three patients with 158 intracranial metastasis consecutively underwent Gamma Knife SRS between January, 2004 and December, 2006. The results were based on last imaging and the date of the last visit. Average age of the patients was 56 years (range 32-84 years). Karnofsky performance status average was 87.6. Fifty-eight (56.3%) patients had single brain metastasis. The average tumor volume was 2.5cc (range 0.02-16.6 cc). The SRS marginal dose average was 23.4 Gy (range 15-25 Gy). Results: Treatment sequence was SRS alone (89 patients) or SRS plus whole-brain radiotherapy (WBRT) (14 patients). The 1-year local control was 80%, being better for tumors with volume <5cc than for ≥5 cc: 86% vs 53% (p<0.05). The 1-year distant brain metastasis-free survival incidence was 73%. The initial number of brain lesions (single vs multiple) was not a significant factor on distant brain metastasis: free survival at 1 year was 75% for single metastases and 70% for multiple lesions. Renal cancer was the only factor with a significant effect on distant brain metastasis. The median overall survival was 15 months. According to unifactorial and multifactorial analysis, three prognostic factors for overall survival were retrieved recursive partitioning analysis (RPA) class, Karnofsky index performance and tumor volume. Conclusion: In this series, SRS provided excellent local control with relatively low morbidity in patients with brain metastases.

Tumor volume as a predictor of survival and local control in patients with brain metastases treated with Gamma Knife surgery

2013 ◽  
Vol 119 (5) ◽  
pp. 1139-1144 ◽  
Author(s):  
Andrew M. Baschnagel ◽  
Kurt D. Meyer ◽  
Peter Y. Chen ◽  
Daniel J. Krauss ◽  
Rick E. Olson ◽  
...  
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Brain Metastases ◽  
Local Control ◽  
Tumor Volume ◽  
Continuous Variable ◽  
Total Tumor Volume ◽  
Extracranial Disease ◽  
Brain Failure ◽  
Distant Brain Failure

Object The aim of this study was to examine tumor volume as a prognostic factor for patients with brain metastases treated with Gamma Knife surgery (GKS). Methods Two hundred fifty patients with 1–14 brain metastases who had initially undergone GKS alone at a single institution were retrospectively reviewed. Patients who received upfront whole brain radiation therapy were excluded. Survival times were estimated using the Kaplan-Meier method. Univariate and multivariate analyses using Cox proportional hazard regression models were used to determine if various prognostic factors could predict overall survival, distant brain failure, and local control. Results Median overall survival was 7.1 months and the 1-year local control rate was 91.5%. Median time to distant brain failure was 8.0 months. On univariate analysis an increasing total tumor volume was significantly associated with worse survival (p = 0.031) whereas the number of brain metastases, analyzed as a continuous variable, was not (p = 0.082). After adjusting for age, Karnofsky Performance Scale score, and extracranial disease on multivariate analysis, total tumor volume was found to be a better predictor of overall survival (p = 0.046) than number of brain metastases analyzed as a continuous variable (p = 0.098). A total tumor volume cutoff value of ≥ 2 cm3 (p = 0.008) was a stronger predictor of overall survival than the number of brain metastases (p = 0.098). Larger tumor volume and extracranial disease, but not the number of brain metastases, were predictive of distant brain failure on multivariate analysis. Local tumor control at 1 year was 97% for lesions < 2 cm3 compared with 75% for lesions ≥ 2 cm3 (p < 0.001). Conclusions After adjusting for other factors, a total brain metastasis volume was a strong and independent predictor for overall survival, distant brain failure, and local control, even when considering the number of metastases.

Stereotactic body radiotherapy (SBRT) for colorectal liver metastasis: Clinical outcomes from the international multi-institutional RSSearch Patient Registry.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15040-e15040
Author(s):  
Pollyanna D'Avila Leite ◽  
Andrew M. Gaya ◽  
Rachelle Marie Lanciano ◽  
Jun J. Yang ◽  
Oliver Blanck ◽  
...  
Keyword(s):  
Overall Survival ◽  
Liver Metastases ◽  
Local Control ◽  
Stereotactic Body Radiotherapy ◽  
Tumor Volume ◽  
Median Number ◽  
Concurrent Chemotherapy ◽  
Patient Registry ◽  
Rank Test ◽  
Primary Tumors

e15040 Background: We investigated factors associated with clinical outcome for liver metastases from colorectal primary tumors treated with Stereotactic Body Radiotherapy (SBRT) from a multi-center, international, prospective patient registry. Methods: A subgroup of patients with colorectal liver metastases treated with SBRT was identified from the RSSearch Patient Registry. Patient, tumor and treatment characteristics associated with outcome were evaluated. Dose fractionations were normalized to BED10. Overall survival (OS) and local control (LC) were evaluated using Kaplan Meier analysis and log-rank test. Results: 217 patients with 233 liver metastases from primary colorectal cancer treated with SBRT between 2005-2017 and enrolled in the RSSearch Patient Registry were included. The median follow-up was 15 months (1–75 months). 77% of patients received prior or concurrent chemotherapy. Median tumor volume was 21.95 cm3 (0.5 – 638 cc), median SBRT dose was 45 Gy (16 – 60 Gy) delivered in a median of 3 fractions (1-5). Median number of liver metastases was 1 (1-8). Median overall survival (OS) was 27 months; median local control (LC) was 41 months. One and two-year OS was 75% and 55%, respectively. One and two-year LC was 75% and 66%, respectively. Higher BED10 was associated with improved LC with median LC of 44 months for BED10 ≥ 100 Gy vs 39 months for BED10 < 100 Gy (p = 0.0007). Higher BED10 was also associated with improved OS: median of 33 months for BED10 ≥ 100 Gy vs to 18 months for BED10 < 100 Gy (p = 0.0009). Smaller tumor volume was associated with improved OS: median OS of tumor volume was 34 months for tumors < 20 cc vs 20 months for tumors ≥ 22cc (p = 0.0037). Local control was not significantly associated with tumor volume: median LC for tumor < 22 cc vs ≥ 22cc was 44 months vs 39 months, respectively (p = 0.193). Age, prior or current chemotherapy and BMI were not associated with OS or LC. Conclusions: In this multi-institutional prospective cohort, OS and LC were favorably correlated with small tumor volume and higher BED10.

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