Lokal ileri küçük hücreli dışı akciğer kanserinde (KHDAK) neoadjuvan kemoradyoterapiye yanıtı öngörmede tedavi öncesi toraks BT belirteçlerinin etkinliğinin değerlendirilmesi

Öz

Amaç: Neoadjuvan kemoradyoterapiye yanıtı veya progresyonu öngörebilecek tedavi öncesi toraks BT bulgularını araştırmak. Gereçler ve yöntemler: Neoadjuvan kemoradyoterapi öncesinde başlangıçta kontrastlı toraks BT taramaları yapılan 140 küçük hücreli dışı akciğer kanseri hastasının bazal toraks BT taramalarından elde edilecek çok sayıda parametre kaydedildi. Tümör dokularının BT özelliklerine ek olarak yaş, cinsiyet, tümör hücre tipleri, lenf nodu, TNM evreleri, bazal toraks BT'de uzak metastazlar, bronşiyal ve vasküler invazyon da değerlendirildi. Neoadjuvan tedavi sırasında 3. ve 6. ayda toraks BT bulguları ve tümör dokusundaki değişiklikler kaydedildi. Neoadjuvan tedavinin bitiminden sonra hastalar ameliyata alındı. Neoadjuvan tedaviye yanıtı hangi parametrelerin öngörebileceği, hangi bulguların progresyonu öngörebileceği araştırıldı. Bulgular: Remisyona giren hastalarda progresyon ve mortalite oranlarının düşük olduğu görüldü (p<0,001). Neoadjuvan tedavi öncesi başlangıçtaki göğüs BT'sindeki parametrelerin hiçbiri neoadjuvan tedaviye yanıtı öngörmedi. Analiz sonuçlarına göre lenf nodu istasyonu olan hastaların progresyona etkisi 3,69 kat [olasılık oranı (OR)=3,693, [%95 güven aralığı (CI)= 1,875–7,274, p=0,041] idi (p <0,001). Sonuç: Neoadjuvan tedavi öncesi bazal göğüs BT incelemesinden elde edilebilecek parametrelerden herhangi birinin neoadjuvan tedavi yanıtını öngörmede başarılı olmadığı görülmüştür. Lenf nodu, progresyonu tahmin edebilen tek bazal toraks BT bulgusudur.

Anahtar Kelimeler

• neoadjuvan kemoradyoterapi
• küçük hücreli dışı akciğer kanseri
• toraks BT
• prognoz
• patolojik yanıt

Evaluation of the efficacy of pretreatment chest CT markers in predicting response to neoadjuvant chemoradiotherapy in locally advanced non-small cell lung cancer (NSCLC)

Öz

Aim: To investigate baseline enhanced chest CT findings that may predict progression or response to neoadjuvant chemoradiotherapy. Materials and methods: Multiple parameters to be obtained from baseline enhanced chest CT scans of 140 patients with NSCLC who had baseline enhanced chest CT scans before neoadjuvant chemoradiotherapy were noted. In addition to CT features of tumour tissues, age, gender, tumour cell types, lymph node TNM stages, distant metastases on baseline enhanced chest CT, bronchial and vascular invasion were also evaluated. Chest CT findings and changes in tumour tissue at 3 and 6 months during neoadjuvant treatment were noted. Patients were operated after the end of neoadjuvant treatment. It was investigated which parameters could predict response to neoadjuvant treatment and which findings could predict progression. Results: Progression and mortality rates were found to be low in patients with remission (p<0.001). None of the parameters on baseline chest CT before neoadjuvant treatment predicted response to neoadjuvant treatment. According to the results of the analysis, patients with lymph node station had a 3.69 -fold efect [odds ratio (OR)=3.693, [95% confdence interval (CI)= 1.875–7.274, p=0.041] effect on progression (p<0.001). Conclusion: It has been observed that any of the parameters that can be obtained from baseline chest CT examination before neoadjuvant treatment are not successful in predicting neoadjuvant treatment response. Lymph node is the only baseline chest CT finding that can predict progression.

Anahtar Kelimeler

• neoadjuvant chemoradiotherapy
• non-small cell lung cancer
• chest CT
• prognosis
• pathologic response

Kaynakça

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