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[Abstract]

OBJECTIVES: We evaluated tumor volume changes in lung cancer patients undergoing concurrent chemoradiotherapy using image-guided radiotherapy.

METHODS: The kilovoltage image was obtained using CT on rail at every five fractions. The gross tumor volumes (GTVs), including the primary tumor and lymph node (LN), were contoured to analyze the time and degree of tumor regression.

RESULTS: Forty-six patients (32, NSCLC and 14, SCLC) were included in this study. In total, 281 CT scans and 82 sites of GTVs were evaluated. Significant volume changes occurred in both the NSCLC and SCLC groups (p<0.001 and 0.002), and the average GTV change compared to baseline was 49.85 ± 3.65 (SE) % and 65.95 ± 4.60 (SE) % for the NSCLC and SCLC groups, respectively. A significant difference in the degree of volume reduction between the primary tumor and LN was observed in only the NSCLC group (P<0.0001), but not in the SCLC group (P=0.735). The greatest volume regression compared to the volume before the five fractions occurred between the 15 and 20 fractions in the NSCLC group and between 5 and 10 fractions in the SCLC group.

CONCLUSIONS: Both primary tumor and LN were well-defined using CT on rail. Significant volume changes occurred during RT, and there was a difference in volume reduction between the NSCLC and SCLC groups, regarding the degree and timing of the tumor reduction in the primary tumor and LN. Advances in knowledge: NSCLC and SCLC groups showed differences in the degree and timing of volume reduction. The primary tumor and LN in NSCLC regressed differently.

Advances in knowledge:

NSCLC and SCLC groups showed differences in the degree and timing of volume reduction. The primary tumor and LN in NSCLC regressed differently. 

[Author information]

Lee YH1, Kim YS1, Lee HC1, Lee SW1, Kang YN1, Kang JH2, Hong SH2, Kim YK3, Kim SJ3, Ahn MI4, Han DH4, Yoo IR5, Park JG6, Sung SW6, Lee KY7.

1 Department of Radiation Oncology, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, South Korea.

2 Department of Medical Oncology, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, South Korea.

3 Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, South Korea.

4 Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, South Korea.

5 Department of Nuclear Medicine, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, South Korea.

6 Department of Thoracic Surgery, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, South Korea.

7 Department of Pathology, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, South Korea.