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    Influence of tumour laterality on patient survival in non-small cell lung cancer after radiotherapy

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    Authors
    McWilliam, Alan
    Vasquez Osorio, Eliana
    Faivre-Finn, Corinne
    van Herk, Marcel
    Affiliation
    Division Clinical Cancer Science, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK
    Issue Date
    2019
    
    Metadata
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    Abstract
    BACKGROUND: Lung cancer survival after radiotherapy remains poor and greater knowledge of normal tissue risk factors is needed to further optimise treatments. In this work, we investigate tumour laterality in a large cohort of patients treated with curative-intent radiotherapy, including the effect of dose on the right and left lungs. METHODS: 1101 NSCLC patients were included in the analysis, treated with 55?Gy in 20 fractions. Tumour laterality was determined by comparing the centre of mass of the tumour volume with the centre of mass of the lung. Right and left lungs were segmented from the whole lung contour and the mean dose to each volume calculated. Laterality and mean lung doses were included in multi-variable cox-regression survival models. RESULTS: 1026 patients were eligible for inclusion; 579 right-sided and 447 left-sided tumours were identified. All tumour and patient characteristics were balanced with laterality. The multi-variable models were controlled for known clinical factors: tumour volume (p?<?0.001), age (p?<?0.001), performance status (p?<?0.05) and nodal stage (p?<?0.01). Multi-variable analysis showed laterality to be highly significant (p?<?0.01) with right-sided tumours showing worse overall survival than left-sided tumours (15 versus 18?months). The right lung mean dose was found to be significant (p?=?0.03) for overall survival but the left lung mean dose was not (p?=?0.78). CONCLUSION: Our study showed that right-sided lung tumours show worse overall survival for NSCLC treated with curative-intent radiotherapy. Results suggest that the effect of laterality is through a difference in dose-response for individual lungs, with the larger, right lung, having the greater impact on survival.
    Citation
    McWilliam A, Vasquez Osorio E, Faivre-Finn C, van Herk M. Influence of tumour laterality on patient survival in non-small cell lung cancer after radiotherapy. Radiother Oncol. 2019;137:71-6.
    Journal
    Radiotherapy and Oncology
    URI
    http://hdl.handle.net/10541/621880
    DOI
    10.1016/j.radonc.2019.04.022
    PubMed ID
    31078940
    Additional Links
    https://dx.doi.org/10.1016/j.radonc.2019.04.022
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.radonc.2019.04.022
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