Non-Small Cell Lung Cancer Coverage from Every Angle

ASTRO 2020: Pericardial Effusion and Survival With Radiation Therapies in Locally Advanced NSCLC

By: Vanessa A. Carter, BS
Posted: Thursday, November 19, 2020

According to a study conducted by Zhongxing Liao MD, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues, a voxel-based analysis may be used to determine the correlation of pericardial effusion–related thoracic dose patterns and mortality in patients with locally advanced non–small cell lung-cancer (NSCLC) treated with passive scattering proton therapy versus intensity-modulated radiotherapy. This research, presented at the 2020 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract 59), may pave the way for further studies on spatial dose distributions, which could shed light on their multiorgan contribution to thoracic toxicities.

The researchers analyzed a total of 178 patients who were treated with either intensity-modulated radiotherapy or passive scattering proton therapy for NSCLC. Each participant was assigned either 66 or 74 Gy in conventional daily fractionation, and all were supplemented with chemotherapy. Endpoints of mortality at 12 and 24 months from irradiation and pericardial effusion of grade 2 or higher were considered, censoring patients for follow-up. Local dose differences were classified according to each endpoint and were assessed via voxel-based analysis.

The median follow-up was 24-months. Multivariable analysis identified a notable correlation between chemoradiotherapy with 1-year pericardial effusion and between age and 2-year pericardial effusion, as the rates were 32% and 47%, with 39 and 88 censored patients, respectively. The 1- and 2-year mortality rates were 28% and 48%, with 2 and 12 censored patients, respectively. Cox analysis showed that although pericardial effusion did not appear to correlate with overall survival, it did for age and gross tumor volume. The voxel-based analysis identified two largely overlapping clusters for 1- and 2-year rates of pericardial effusion in the heart and the lungs but did not show substantial dosimetric patterns related to mortality endpoints.

Disclosure: The study authors reported no conflicts of interest.

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