ISSN: 1859 - 2872
Clinical, paraclinical and PET/CT imaging characteristics in patients with early-stage non-small cell lung cancer who have indicated stereotactic body radiation therapy
Main Article Content
Keywords
Abstract
Objective: To describe the clinical, paraclinical and PET/CT imaging characteristics in patients with early-stage non-small cell lung cancer who have indicated stereotactic body radiation therapy. Subject and method: A descriptive, cross-sectional study. 32 patients with NSCLC stage I (T1-2aN0M0) and peripheral tumor, who were considered SBRT, from January 2015 to November 2021. The patients were clinically examined, performed paraclinical tests to confirm the diagnosis, staging, pulmonary ventilation, and PET/CT scan before receiving stereotactic body radiation therapy. Result: The median age was 67 years old, 25% of the patients were 75 years or older, most of them were men (65.6%) and had a smoking history (59.4%). Cough and chest pain were the two most common clinical symptoms, accounting for 62.5% and 46.9%, respectively. 50% of patients had a performance status of 2 according to ECOG, the tumor was mainly in the right lung (56.3%), adenocarcinoma (78.2%). Only 35.5% of patients had an increase in CEA and 22.6% had an elevation of Cyfra 21-1, there was a positive, moderate, statistically significant correlation between Cyfra 21-1 concentration and tumor size with r = 0.436, p=0.014. The median tumor size was 2.95cm, the median SUVmax was 7.95, mainly tumors at T2a stage (43.7%). The rate of T1a and T1b stages on chest CT scan was 25% and 31.3%, respectively, on PET/CT, these two stages were respectively 18.8%, 37.5%, the difference was statistically significant with p<0.05. 50% of patients had obstructive ventilation disorder on pulmonary ventilation results. Conclusion: Most of the patients were elderly, with cough, chest pain and mostly adenocarcinoma. There was a moderate positive correlation between Cyfra 21-1 and tumor size. PET/CT imaging results has statistically significant changes in the ratio of T1a and T1b stages compared with chest CT.
Article Details
References
2. Jessica D, Mark F, Peter M et al (2012) American college of chest physicians and society of thoracic surgeons consensus statement for evaluation and management for high-risk patients with stage I non-small cell lung cancer. Chest 142(6): 1620-1635.
3. Bryan JS, Megan ED, Erin BK et al (2017) Stereotactic Body Radiation Therapy for Early-stage non-small cell lung cancer: American Society for Clinical Oncology Endorsement of the American Society for Radiation Oncology Evidence-Based Guideline. J Clin Oncol 36: 710-719.
4. National Comprehensive Cancer Network, NCCN Clinical Practice Guidelines in Oncology, Non-Small Cell Lung Cancer, version 1.2022 Available from: https://www.nccn.org/.
5. Gerard AS, Anne V, Michael AJ et al (2013) Methods for staging non-small cell lung cancer: diagnosis and management of lung cancer, 3rd ed: American college of chest physicians evidence-based clinical practice guidelines. Chest 143(5): 211-250.
6. Kandathil A, Kay FU, Butt YM, et al (2018) Role of FDG PET/CT in the eighth edition of TNM staging of non-small cell lung cancer. Radio Graphics 38: 2134-2149.
7. Verschakelen JA, Bogaert J, De Wever W, Computed tomography in staging for lung cancer. Eur Respir J 19: 35-48.
8. Soffiettia R, Cornub P, Delattre JY et al (2006) EFNS Guidelines on diagnosis and treatment of brain metastases: Report of an EFNS Task Force. European Journal of Neurology 13: 674-681.
9. Rami-Porta R, Giroux DJ, Goldstraw P (2011) The new TNM classification of lung cancer in practice. Breathe 7: 348-360.
10. Linjie Liu, Jinlong Teng, Lijun Zhang et al (2017) The combination of the tumor markers suggests the histological fiagnosis of lung cancer. BioMed Research International Article ID 2013989, 9pp.
11. Christopher GC, Robert Greenberg E, John Baron et al (1985) Presenting conditions of i539 population-based lung cancer patients by cell type and stage in new hampshire and vermont. Cancer 56: 2107-2111.
12. Bauman P, Nyman J, Hoyer M et al (2009) Outcome in a Prospective Phage II Trial of Medically Inoperable stage I non-small cell lung cancer patients treated with Stereotactic Body Radiation Therapy. J Clin Oncol 27: 3290-3296.
13. Nagata Y, Hiraoka M, Shibata T et al (2012) Stereotactic Body Radiation Therapy for T1N0M0 Non-small Cell Lung Cancer First Report for Inoperable Population of a Phase II Trial by Japan Clinical Oncology Group (JCOG 0403). Int J Radiat Oncol Biol Phys 84: 46-46.
14. Gregory MMV, Chen Hu, Anurag KS et al (2015) NRG Oncology RTOG 0915 (NCCTG N0927): A Randomized phase II study comparing 2 stereotactic Body Radiation Therapy (SBRT) schedules for medically inoperable patients with stage i peripheral non-small cell lung cancer. Int J Radiat Oncol Biol Phys 93(4): 757-764.
15. Katsunari M, Shinichi S, Nariyasu N et al (2007) Prognostic value of carcinoembryonic antigen and CYFRA21-1 in patients with pathological stage I non-small cell lung cancer. European Journal of Cardio-thoracic Surgery 32: 435-439.
16. Zhong-qing Chen, Ling-sha Huang and Bo Zhu (2018) Assessment of seven clinical tumor markers in diagnosis of non-small-cell lung cancer. Disease Markers Article ID 9845123, 7 pages.
17. Lee J, Lee M, Koom WS et al (2018) Metabolic positron emission tomography parameters predict failure patterns in early non-small-cell lung cancer treated with stereotactic body radiation therapy: a single institution experience. Japanese Journal of Clinical Oncology 48(10): 920-926.
18. Horne ZD, David A Clump, John A Vargo et al (2014) Pretreatment SUVmax predicts progression-free survival in early-stage non-small cell lung cancer treated with stereotactic body radiation therapy. Radiation Oncology 9: 41.
19. Funda A, Levent D, Evrim SB et al (2013) Measurements of tumor size using CT and PET compared to histopathological size in non-small cell lung cancer. Diagn Interv Radiol 19: 271-278.
Article Sidebar
