Short-term restaging of patients with non-small cell lung cancer receiving chemotherapy

OBJECTIVE: To determine whether computed tomography (CT) performed within a month of receiving chemotherapy is useful in assessing response among patients with non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: Consecutive patients receiving chemotherapy for NSCLC who underwent short-term CT restaging between April 2001 and June 2005 were included in the study. Serial CT scans were performed within 31 days (mean, 24 days; range, 9-31 days) after receiving chemotherapy for all patients. Tumors were measured in consensus by two diagnostic radiologists. Tumor response was assessed using uni-dimensional tumor measurements according to Response Evaluation Criteria in Solid Tumors criteria. RESULTS: There were 57 patients in the study (30 men, 27 women; mean age, 63 years; age range, 37-85 years). Tumor histology included adenocarcinoma (n = 30), squamous cell carcinoma (n = 17), and NSCLC otherwise unspecified (n = 10). Clinical tumor, node, metastasis stage was stage II (n = 2), stage III (n = 11), and stage IV (n = 44). A significant change in tumor size was observed in eight patients (14%), with tumor regression in two (3%) and progression in six (11%). For these patients, CT scans were performed within 31 days (mean, 25 days; range, 17-31 days). Among the six patients with tumor progression, early detection of therapeutic failure resulted in a change or a discontinuation of chemotherapy for five. CONCLUSION: Early restaging CT is useful in evaluating therapeutic response among patients with NSCLC and may allow the institution of more appropriate therapy.