Cone-beam computed tomography in lung stereotactic ablative radiation therapy: predictive parameters of early response

Mazzola, Rosario; Fiorentino, Alba; Ricchetti, F.; Levra, Niccolò Giaj; Fersino, S.; Paola, Gioacchino Di; Casto, Antonio Lo; Ruggieri, R.; Alongi, Filippo

doi:10.1259/bjr.20160146

Cited by 15 publications

(17 citation statements)

References 36 publications

(42 reference statements)

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“…Per this suggestion, we found that BED 10 correlated with better tumor response to SABR. Previous studies have also shown that the shrinkage of the lung lesion by at least 20% at the last session of SABR, combined with the mean and maximum pre-SABR standard uptake values, were predictive of complete response 6 months after SABR [16, 17]. Our investigation did identify an additional factor, the pre-SABR CD8+CD28+ T-cell count, as predictive of early tumor response to SABR.…”

Section: Discussionsupporting

confidence: 63%

“…However, markers to predict early tumor response to SABR have not been investigated thoroughly. A previous study revealed that at least a 20% lung lesion shrinkage by the final session of SABR could be predictive of a complete response within 6 months [16]. Also, Mazzola et al [17] reported the mean and maximum values of pre-SABR standard uptake value to be both significantly correlated with a complete response within 6 months after SABR treatment of lung metastases from various primary tumors.…”

Section: Introductionmentioning

confidence: 99%

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Increased CD8+CD28+ T cells independently predict better early response to stereotactic ablative radiotherapy in patients with lung metastases from non-small cell lung cancer

Liu

et al. 2019

J Transl Med

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Background Stereotactic ablative radiotherapy (SABR) shows a remarkable local control of non-small cell lung cancer (NSCLC) metastases, partially as a result of host immune status. However, the predictors of immune cells for tumor response after SABR are unknown. To that effect, we investigated the ability of pre-SABR immune cells in peripheral blood to predict early tumor response to SABR in patients with lung metastases from NSCLC. Methods This study included 70 patients with lung metastases from NSCLC who were undergoing SABR. We evaluated the early tumor response 1 month and 6 months after SABR in these patients following RECIST 1.1 guidelines. Pre-SABR peripheral CD8+ T cell count, CD8+CD28+ T-cell count, CD8+CD28− T-cell count, CD4+ T-cell count, and Treg-cell count were measured using flow cytometry. Results Increased CD8+CD28+ T-cell counts (14.43 ± 0.65 vs. 10.21 ± 0.66; P = 0.001) and CD4/Treg ratio (16.96 ± 1.76 vs. 11.91 ± 0.74; P = 0.011) were noted in 1-month responsive patients, compared with non-responsive patients. In univariate logistic analyses, high CD8+CD28+ T-cell counts (OR 0.12, 95% CI 0.03–0.48; P = 0.003), CD4/Treg ratio (OR 0.24, 95% CI 0.06–0.90; P = 0.035), and BED 10 (OR 0.91, 95% CI 0.84–0.99; P = 0.032) predicted a 1-month tumor response to SABR. According to multivariate logistic analyses, the CD8+CD28+ T-cell count predicted a 1-month tumor response to SABR (OR 0.19, 95% CI 0.04–0.90; P = 0.037) independently. Furthermore, we confirmed the independent predictive value of the CD8+CD28+ T-cell count in predicting tumor response to SABR in 41 patients 6 months after treatment (OR 0.08, 95% CI 0.01–0.85; P = 0.039). Conclusions A pre-SABR CD8+CD28+ T-cell count could predict early tumor response to SABR in patients with lung metastases from NSCLC. Larger, independently prospective analyses are warranted to verify our findings. Electronic supplementary material The online version of this article (10.1186/s12967-019-1872-9) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 63%

Section: Introductionmentioning

confidence: 99%

Increased CD8+CD28+ T cells independently predict better early response to stereotactic ablative radiotherapy in patients with lung metastases from non-small cell lung cancer

Liu

et al. 2019

J Transl Med

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“…At the last session of SABR, a lung lesion shrinkage of at least 20% was revealed to be predictable of complete response 6 months thereafter. 30 Several metabolic predictive factors for recurrence and survival after SABR for primary lung cancer have already been investigated by several studies. [31][32][33] Similarly, the present study was designed to investigate the role of 18 FDG-PET/CT parameters as predictive of early response after SABR in the setting of lung oligometastases.…”

Section: Discussionmentioning

confidence: 99%

Stereotactic Ablative Radiation Therapy for Lung Oligometastases: Predictive Parameters of Early Response by 18 FDG-PET/CT

Mazzola

Fiorentino

Paola

et al. 2017

Journal of Thoracic Oncology

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In the current analysis, complete response from lung metastasis at 6 months after stereotactic body radiation therapy was significantly associated with both the maximum and mean values of pre-SABR FDG-PET/CT SUV. Longer-term trials are strongly advocated to improve the personalization of the monitoring of tumor response in patients with lung oligometastases and, consequently, monitoring of the cost-effectiveness of the health care.

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“…However, our cases represent a study with regular regimens. Second, the accuracy of the values was influenced by the different slice thicknesses used in CT and CBCT reconstriction and by the potential limit of CBCT in soft-tissue contrast compared with CT, which could result in uncertainties 36 . A slower gantry speed or Monte Carlo-based scatter correction may improve the CBCT image quality 37 , 38 .…”

Section: Discussionmentioning

confidence: 99%

“…As Mazzola et al . showed, another limitation was that the CBCT CT number may not represent the real HU due to various artefacts, including body scattering 36 . However, the utility of delta CT number could reflect the actual biological changes of tumors and minimize the interference from influencing factors, especially when we considered that the image acquisition conditions were consistent among serial CBCT.…”

Section: Discussionmentioning

confidence: 99%

The Value of CBCT-based Tumor Density and Volume Variations in Prediction of Early Response to Chemoradiation Therapy in Advanced NSCLC

Wen

Zhu

Meng

et al. 2017

Sci Rep

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The correlations between early responses and the variations in physical density and primary tumor volume (TV) according to cone-beam computed tomography (CBCT) during chemoradiotherapy for non-small cell lung cancer (NSCLC) patients were investigated. 54 patients with inoperable and locally advanced NSCLC were included in this study. The CT numbers (CTN) and TV were measured on each of the seven observation points. The changes in the mean CTN values and the variation ratios of TV during the treatment course were analysed and correlated with the clinical outcomes, as evaluated by the RECIST criteria. For patients who responded to treatment, the CTN and TV change ratio decreased by 28.44 ± 13.12 HU and 32.01% (range, 8.46–61.67%); these values were significantly higher than those in the non-responding patients, with 19.63 ± 8.67 HU and 23.20% (range, −15.57–38%) (p = 0.016, p = 0.048), respectively. The area under curve for the combination of CTN and TV was larger than either alone (AUC = 0.751, p = 0.002). The differences between response and non-response were most significant between Fraction 10 and Fraction 15 for CTN changes and between Fraction 5 and Fraction 10 for the TV regression ratio. The changes in CTN and TV obtained from CBCT images have the potential capability to predict an early response of NSCLC.

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Cone-beam computed tomography in lung stereotactic ablative radiation therapy: predictive parameters of early response

Cited by 15 publications

References 36 publications

Increased CD8+CD28+ T cells independently predict better early response to stereotactic ablative radiotherapy in patients with lung metastases from non-small cell lung cancer

Increased CD8+CD28+ T cells independently predict better early response to stereotactic ablative radiotherapy in patients with lung metastases from non-small cell lung cancer

Stereotactic Ablative Radiation Therapy for Lung Oligometastases: Predictive Parameters of Early Response by 18 FDG-PET/CT

The Value of CBCT-based Tumor Density and Volume Variations in Prediction of Early Response to Chemoradiation Therapy in Advanced NSCLC

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