INTRODUCTION The aim of this study was to identify subgroups of locally advanced NSCLC patients with a distinct treatment response during concurrent chemoradiotherapy (CCRT). Subsequently, we investigated the association of subgroup membership with treatment outcomes. METHODS 394 NSCLC-patients treated with CCRT between 2007 and 2013 were included. Gross Tumor Volume (GTV) during treatment was determined and relative GTV-volume change from the planning-CT was subsequently calculated. Latent Class Mixed Modeling (LCMM) was used to identify subgroups with distinct volume changes during CCRT. The association of subgroup membership with overall survival (OS), progression free survival (PFS) and local regional control (LRC) was assessed using cox regression analyses. RESULTS Three subgroups of GTV-volume change during treatment were identified, with each subsequent subgroup showing a more profound reduction of GTV during treatment. No associations between subgroup membership and OS, PFS nor LRC were observed. Nonetheless, baseline GTV (HR1.42; 95%CI 1.06-1.91) was significantly associated with OS. CONCLUSIONS Three different subgroups of GTV-volume change during treatment were identified. Surprisingly, these subgroups did not differ in their risk of treatment outcomes. Only patients with a larger GTV at baseline had a significantly worse OS. Therefore, risk stratification at baseline might already be accurate in identifying the best treatment strategy for most patients.

中文翻译：

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非小细胞肺癌患者同步放化疗期间锥形束CT测量原发肿瘤体积变化的预后价值

引言 本研究的目的是确定在同步放化疗 (CCRT) 期间具有不同治疗反应的局部晚期 NSCLC 患者亚组。随后，我们调查了亚组成员与治疗结果的关联。方法 纳入 2007 年至 2013 年间接受 CCRT 治疗的 394 名 NSCLC 患者。确定治疗期间的总肿瘤体积 (GTV)，随后计算相对于计划 CT 的 GTV 体积变化。潜在类别混合建模 (LCMM) 用于识别在 CCRT 期间具有不同体积变化的亚组。使用 cox 回归分析评估亚组成员与总生存期 (OS)、无进展生存期 (PFS) 和局部区域控制 (LRC) 的关联。结果 确定了治疗期间 GTV 体积变化的三个亚组，随后的每个亚组都显示出治疗期间 GTV 的更显着降低。未观察到亚组成员与 OS、PFS 或 LRC 之间的关联。尽管如此，基线 GTV (HR1.42; 95% CI 1.06-1.91) 与 OS 显着相关。结论 确定了治疗期间 GTV 体积变化的三个不同亚组。令人惊讶的是，这些亚组的治疗结果风险没有差异。只有基线时 GTV 较大的患者的 OS 明显更差。因此，基线时的风险分层可能已经准确地确定了大多数患者的最佳治疗策略。91) 与 OS 显着相关。结论 确定了治疗期间 GTV 体积变化的三个不同亚组。令人惊讶的是，这些亚组的治疗结果风险没有差异。只有基线时 GTV 较大的患者的 OS 明显更差。因此，基线时的风险分层可能已经准确地确定了大多数患者的最佳治疗策略。91) 与 OS 显着相关。结论 确定了治疗期间 GTV 体积变化的三个不同亚组。令人惊讶的是，这些亚组的治疗结果风险没有差异。只有基线时 GTV 较大的患者的 OS 明显更差。因此，基线时的风险分层可能已经准确地确定了大多数患者的最佳治疗策略。