Keywords:
Lung, Oncology, CT, Chemotherapy, Radiation therapy / Oncology, Cancer, Monoclonal antibodies
Authors:
C. Moroni, D. Cozzi, M. Bartolucci, F. Giannelli, V. Bonti, V. Scotti, F. Mazzoni, V. Miele; Florence/IT
DOI:
10.26044/ecr2019/C-0980
Methods and materials
In this retrospective study,
toghether with the Departments of Oncology and Radiotherapy of our Institution,
we evaluated patients with NSCLC stage IIIb/IV receiving second-line Nivolumab therapy.
Period: January 2016 - March 2018.
Patients: n= 56,
all with the following demographic data: age,
gender,
stage of the disease,
tumour histology, Pack-years (if smokers).
Inclusion criteria:
- patients with NSCLS stage IIIb–IV receiving Nivolumab in 2°line therapy
- one target lesion at least
- follow up > 3 months
- 2 or more follow up CT
- failure of 1° line chemotherapy.
Exclusion criteria: 36 patients were excluded because of:
- absence of target lesions (n=11)
- relapsing lesions after radiotherapy (n=2)
- previous radiotherapy (n=4)
- skeletal metastases (n=4)
- follow up < 3 months (n=8)
- absence of follow up CT (n=3)
CT examinations and images interpretation: All patients performed a pre-treatment whole body CT scan and,
at least,
2 follow-up ones (SomatomDefinition AS 128,
Siemens,
Erlangen Germany).
All CT examinations were performed at baseline and post endovenuos injection of contrast media (arterial and venous phase).
We injected 90-120 ml of contrast media with a flow rate of 3.5 ml/s andin order a bolus tracking technique (Care Bolus; Siemens).
Transverse images were contiguously reconstructed at 1 mm with a smooth reconstruction kernel for mediastinal structures and a sharp one for lung parenchymal evaluation. Images were evaluated by two radiologists dedicated to thoracic imaging.
iRECIST criteria were used in order to define the radiological pattern of response. According to iRECIST criteria we classified our parients into the following groups: Hyperprogression,
Pseudoprogression and Other Responders (OR).
In OR were included all the following: Complete Responders (CR),
Partial Responders (PD),
Stable Disease (SD) and Progressive Disease (PD),
Statystical analysis: Chi-square Test and Fisher's Exact Test were used for statistical analysis.