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Early osteosclerotic changes predict chemotherapy response in non-small-cell lung cancer patients with bone metastases

  • Computed Tomography
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Abstract

Objectives

To explore the relationship between osteosclerotic changes and chemotherapy response in non-small-cell lung cancer (NSCLC) patients with bone metastases (BM).

Methods

Fifty-two NSCLC patients with BM were enrolled from 1 January 2010–31 June 2015 and divided into two groups based on their CT features: an osteosclerotic change (OC) group and a no-osteosclerotic change (NOC) group. The disease control rate (DCR) was evaluated, and progression-free survival (PFS) was analysed using Kaplan-Meier curves. Univariate and multivariate Cox regression analyses were performed to analyse the factors that could affect PFS.

Results

Osteosclerotic changes were observed in 35/52 patients. The median interval when osteosclerotic changes occurred was 2 months (range 1–3 months) after chemotherapy. The OC group had a significantly higher 3-month DCR than the NOC group (p < 0.001). The OC group had a higher 1-year PFS rate than the NOC group (1-year PFS: 74.9% vs. 30.2%, p < 0.001). Univariate Cox regression analysis indicated that pathological subtype (HR = 4.419; 95% CI = 1.635–11.941, p = 0.003) and osteosclerotic changes (HR = 0.199; 95% CI = 0.083–0.477, p < 0.001) were significant predictors of PFS.

Conclusion

Early osteosclerotic changes predict chemotherapy response in NSCLC patients with BM.

Key Points

• Osteosclerotic changes were prevalent CT features after chemotherapy in NSCLC patients.

• Osteosclerotic changes were positively related to increased 3-month DCR.

• Osteosclerotic changes were positively related to increased 1-year PFS rate.

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Abbreviations

BM:

Bone metastases

CT:

Computed tomography

DCR:

Disease control rate

NOC:

Without osteosclerotic changes

NSCLC:

Non-small-cell lung cancer

OC:

Osteosclerotic changes

PFS:

Progression-free survival

References

  1. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM (2010) Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 127:2893–2917

    Article  CAS  Google Scholar 

  2. Yu JL, Simmons C, Victor JC et al (2011) Impact of new chemotherapeutic and targeted agents on survival in stage IV non-small cell lung cancer. Oncologist 16:1307–1315

    Article  CAS  Google Scholar 

  3. Ettinger DS, Akerley W, Borghaei H et al (2013) Non-small cell lung cancer, version 2.2013. J Natl Compr Cancer Netw 11:645–653 quiz 653

    Article  Google Scholar 

  4. Torre LA, Siegel RL, Jemal A (2016) Lung Cancer Statistics. Adv Exp Med Biol 893:1–19

    Article  Google Scholar 

  5. Reck M, Popat S, Reinmuth N et al (2014) Metastatic non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 25:iii27–iii39

    Article  Google Scholar 

  6. Besse B, Adjei A, Baas P et al (2014) 2nd ESMO Consensus Conference on Lung Cancer: non-small-cell lung cancer first-line/second and further lines of treatment in advanced disease. Ann Oncol 25:1475–1484

    Article  CAS  Google Scholar 

  7. Ettinger DS, Wood DE, Akerley W et al (2016) NCCN Guidelines Insights: Non-Small Cell Lung Cancer, Version 4.2016. J Natl Compr Canc Netw 14:255–264

    Article  Google Scholar 

  8. Hoang T, Dahlberg SE, Sandler AB, Brahmer JR, Schiller JH, Johnson DH (2012) Prognostic models to predict survival in non-small-cell lung cancer patients treated with first-line paclitaxel and carboplatin with or without bevacizumab. J Thorac Oncol Off Publ Int Assoc Study Lung Cancer 7:1361–1368

    CAS  Google Scholar 

  9. Kouloulias EV, Kouvaris RJ, Antypas C et al (2003) An intra-patient dose-escalation study of disodium pamidronate plus radiotherapy versus radiotherapy alone for the treatment of osteolytic metastases. Monitoring of recalcification using image-processing techniques. Strahlenther Onkol 179:471–479

    Article  Google Scholar 

  10. Quattrocchi CC, Piciucchi S, Sammarra M et al (2007) Bone metastases in breast cancer: higher prevalence of osteosclerotic lesions. Radiol Med 112:1049

    Article  CAS  Google Scholar 

  11. Amir E, Whyne C, Freedman OC et al (2009) Radiological changes following second-line zoledronic acid treatment in breast cancer patients with bone metastases. Clin Exp Metastasis 26:479–484

    Article  CAS  Google Scholar 

  12. Yamashita Y, Aoki T, Hanagiri T et al (2012) Osteosclerotic lesions in patients treated with gefitinib for lung adenocarcinomas: a sign of favorable therapeutic response. Skeletal Radiol 41:409–414

    Article  Google Scholar 

  13. Rief H, Bischof M, Bruckner T et al (2013) The stability of osseous metastases of the spine in lung cancer – a retrospective analysis of 338 cases. Radiat Oncol 8:1–7

    Article  Google Scholar 

  14. Robert F, Christian E, Thomas B et al (2015) Bone density as a marker for local response to radiotherapy of spinal bone metastases in women with breast cancer: a retrospective analysis. Radiat Oncol 10:1–7

    Article  Google Scholar 

  15. Huang Q, Ouyang X (2013) Bone markers for monitoring efficacy in patients with bone metastases receiving zoledronic acid: a review of published data. Int J Biol Markers 28:242–248

    Article  CAS  Google Scholar 

  16. Hamaoka T, Madewell JE, Podoloff DA, Hortobagyi GN, Ueno NT (2004) Bone imaging in metastatic breast cancer. J Clin Oncol Off J Am Soc Clin Oncol 22:2942–2953

    Article  Google Scholar 

  17. Watanabe H, Okada M, Kaji Y et al (2009) New response evaluation criteria in solid tumours-revised RECIST guideline (version 1.1). Gan To Kagaku Ryoho 36:2495–2501

    PubMed  Google Scholar 

  18. Weilbaecher KN, Guise TA, Mccauley LK (2011) Cancer to bone: a fatal attraction. Nat Rev Cancer 11:411–425

    Article  CAS  Google Scholar 

  19. Ell B, Kang Y (2012) SnapShot: Bone Metastasis. Cell 151:690

    Article  CAS  Google Scholar 

  20. Pienta KJ, Robertson BA, Coffey DS, Taichman RS (2013) The Cancer Diaspora: Metastasis beyond the seed and soil hypothesis. Clin Cancer Res An Off J Am Assoc Cancer Res 19:5849–5855

    Article  Google Scholar 

  21. Roato I (2014) Bone metastases: When and how lung cancer interacts with bone. World J Clin Oncol 5:149–155

    Article  Google Scholar 

  22. Suva LJ, Washam C, Nicholas RW, Griffin RJ (2011) Bone metastasis: mechanisms and therapeutic opportunities. Nat Rev Endocrinol 7:208–218

    Article  CAS  Google Scholar 

  23. Coleman RE (1997) Skeletal complications of malignancy. Cancer 80:1588–1594

    Article  CAS  Google Scholar 

  24. Weidle UH, Birzele F, Kollmorgen G, Rüger R (2016) Molecular Mechanisms of Bone Metastasis. Cancer Genomics Proteomics 13:1

    Article  CAS  Google Scholar 

  25. Zheng H, Li W, Kang Y (2017) Tumor-Stroma Interactions in Bone Metastasis: Molecular Mechanisms and Therapeutic Implications. Cold Spring Harb Symp Quant Biol 81:151–161

    Article  Google Scholar 

  26. Chang CY, Simeone FJ, Torriani M, Bredella MA (2017) Quantitative contrast-enhanced CT attenuation evaluation of osseous metastases following chemotherapy. Skeletal Radiol. https://doi.org/10.1007/s00256-017-2706-6

    Article  Google Scholar 

  27. Hayashi N, Costelloe CM, Hamaoka T et al (2013) A prospective study of bone tumor response assessment in metastatic breast cancer. Clin Breast Cancer 13:24–30

    Article  Google Scholar 

Download references

Acknowledgements

We thank the native English-speaking scientists of American Journal Experts for editing our manuscript.

Funding

The authors state that this work has not received any funding.

Author information

Author notes

  1. Dailin Rong and Yize Mao contributed equally to this work.

Authors and Affiliations

  1. State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, People’s Republic of China

    Dailin Rong, Yize Mao, Qiuxia Yang, Qianqian Zhao & Rong Zhang

  2. Department of Radiology, Sun Yat-Sen University Cancer Center, No. 651 Dongfeng Road East, Guangzhou, 510060, People’s Republic of China

    Dailin Rong, Qiuxia Yang, Qianqian Zhao & Rong Zhang

  3. Department of Ultrasound, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, Guangdong Province, People’s Republic of China

    Shuhang Xu

Authors
  1. Dailin Rong
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  2. Yize Mao
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  4. Shuhang Xu
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  6. Rong Zhang
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Corresponding author

Correspondence to Rong Zhang.

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Guarantor

The scientific guarantor of this publication is Rong Zhang, Sun Yat-Sen University Cancer Center

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was not required for this study because this was a retrospective study

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• observational

• performed at one institution

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Rong, D., Mao, Y., Yang, Q. et al. Early osteosclerotic changes predict chemotherapy response in non-small-cell lung cancer patients with bone metastases. Eur Radiol 28, 4362–4369 (2018). https://doi.org/10.1007/s00330-017-5253-6

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  • DOI: https://doi.org/10.1007/s00330-017-5253-6

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