A Pilot Study Examining the Prognostic Utility of Tumor Shrinkage on Cone-Beam Computed Tomography (CBCT) for Stage III Locally Advanced Non-Small Cell Lung Cancer Patients Treated with Definitive Chemoradiation

There has been growing interest in utilizing information from cone-beam computed tomography (CBCT) to help guide both treatment delivery and prognosis. In this assessment of locally advanced unresectable stage III non-small cell lung cancer (NSCLC) treated with definitive chemoradiation, we aimed determine the survival advantage associated using CBCT measure tumor regression. Patient, tumor, characteristics were collected. The serial shrinkage for each patient was determined volume contours on weekly CBCTs. Survival analysis performed Kaplan–Meier technique a Cox proportional hazards model. At least two-thirds patients had reduction at 5% after week chemoradiation. A or greater seen images during radiation therapy significantly improved overall survival, which remained significant when adjusted age, histology, grade, T- N-stages (p = 0.0036). Additionally, presence N3 disease five-fold increased risk recurrence 0.0006) nearly three-fold death 0.053) compared N0–N2 disease. Tumor observed chemoradiation holds promise as prognostic indicator NSCLC, especially given its affordability, availability, applicability. Further evaluation prospective fashion is warranted validate clinical utility.