Evaluation of post-lung SABR imaging: A proposed pathway
2024; Elsevier BV; Volume: 192; Linguagem: Inglês
10.1016/j.radonc.2024.110083
ISSN1879-0887
AutoresDe Bruycker Aurélie, Schneiders Famke, Suresh Senan,
Tópico(s)Medical Imaging and Pathology Studies
ResumoWe read with interest the findings by Gulstene et al. which confirm the poor predictive value (PPV = 0.16) of using RECIST criteria for assessment of local tumor progression after lung stereotactic ablative radiotherapy (SABR) [ [1] Gulstene S. Lang P. Melody Q.X. Laba J.M. Yaremko B.P. Rodrigues G.B. et al. What is the predictive value of RECIST criteria following stereotactic lung radiation?. Radiother. Oncol. 2023; 190109976 PubMed Google Scholar ]. While two thirds of their patients met the RECIST criteria of progression, namely a ≥20% and ≥5 mm increase in diameter from prior minimum lesion size, true local progression in their study was established in only 10% of patients [ [1] Gulstene S. Lang P. Melody Q.X. Laba J.M. Yaremko B.P. Rodrigues G.B. et al. What is the predictive value of RECIST criteria following stereotactic lung radiation?. Radiother. Oncol. 2023; 190109976 PubMed Google Scholar ]. These observations accentuate the daily challenges that tumor boards face as SABR has become instituted in routine care and is being used in fitter patients. For example, a prospective study performed in patients with biopsy-proven early-stage non-small-cell lung cancer observed local recurrences (LR) in just 6% of patients (95% CI, 2–13) after a median follow-up of 61 months [ [2] Chang J.Y. Mehran R.J. Feng L. Verma V. Liao Z. Welsh J.W. et al. Stereotactic ablative radiotherapy for operable stage I non-small-cell lung cancer (revised STARS): long-term results of a single-arm, prospective trial with prespecified comparison to surgery. Lancet Oncol. 2021; 22 (10): 1448-1457 Abstract Full Text Full Text PDF PubMed Scopus (143) Google Scholar ]. Response to evaluation of post-lung SABR imaging: A proposed pathwayRadiotherapy and OncologyVol. 192PreviewWe would like to thank De Bruycker et al. for their recent letter [1]. Their algorithm is well-outlined and provides a practical approach to assessing treatment response to help clinicians following patients after lung SABR. The focus on specific radiographic features suggestive of local recurrence should help improve the specificity of identifying recurrence. The specific features that they include are: sequential enlarging opacity, bulging margin, craniocaudal growth, loss of linear margin, and loss of air bronchogram [1]. Full-Text PDF
Referência(s)