2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.08B.03 Prognostic Value of Irradiated Cardiac and Metabolic Tumor Volume in Unresected LA-NSCLC Treated with Concurrent Chemo-Radiotherapy.

EP.08B.03 Prognostic Value of Irradiated Cardiac and Metabolic Tumor Volume in Unresected LA-NSCLC Treated with Concurrent Chemo-Radiotherapy.

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This retrospective analysis examined records from Juravinski and Walker Family Cancer Centers in Ontario, Canada, focusing on patients with unresected stage III non-small cell lung cancer (NSCLC) treated with concurrent chemoradiotherapy (cCRT) from 2007 to 2017. The study aimed to identify prognostic markers for overall survival (OS) and involved evaluating imaging from brain MRI, and FDG-PET scans.<br /><br />A total of 186 patients, with a median age of 67, were involved. The study found that pre-treatment metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were prognostic for OS but maximum standardized uptake value (SUVmax) was not. Additionally, the study highlighted that radiation doses to the heart (measured as mean heart dose (MHD) and cardiac volumes receiving 8Gy and 45Gy) were also important prognostic factors.<br /><br />The analysis used the Kaplan-Meier method for estimating OS and Cox regression for exploring prognostic factors. The OS rates at 1, 2, and 5 years post-cCRT were found to be 81.6%, 60.0%, and 36.7%, respectively.<br /><br />Key findings included that higher cardiac doses were significantly associated with worse OS, paralleling previous meta-analyses. However, combining MTV with MHD did not improve prognostic significance, suggesting that each factor independently contributes to patient outcomes. No significant prognostic value was found for planning target volume (PTV), gross tumor volume (GTV), or doses affecting normal lung and esophagus tissue.<br /><br />The study concluded that baseline tumor metabolic activity and heart radiation exposure are reliable prognostic factors. It underscored the need for further research with larger datasets to validate these indicators due to the complex anatomical distribution associated with locally advanced NSCLC.

Asset Subtitle

Andre Gouveia

Meta Tag

Speaker Andre Gouveia

Topic Local-Regional Non-small Cell Lung Cancer

Keywords

non-small cell lung cancer

concurrent chemoradiotherapy

prognostic markers

overall survival

metabolic tumor volume

total lesion glycolysis

mean heart dose

Kaplan-Meier method

Cox regression

radiation exposure