title: Innovative method using circulating tumor cells for prediction of the effects of induction therapy on locally advanced non-small cell lung cancer.
abstract: BACKGROUND
  The existence of circulating tumor cells (CTCs) in patients with lung cancer has been reported. The purpose of this study was to assess whether CTCs are predictive of the pathological effects of induction chemoradiotherapy for patients with non-small cell lung cancer.
  
  
  METHODS
  Patients who underwent induction chemoradiotherapy followed by surgery were compared with those who underwent surgery alone. Peripheral and pulmonary venous blood samples from the involved lobe were collected intraoperatively, and the number of CTCs was counted using the CellSearch™ system, an epithelial cell adhesion molecule-based immunomagnetic technique.
  
  
  RESULTS
  Of the 9 patients who underwent induction therapy, 4 achieved pathological CR, 4 achieved major response, and 1 achieved minor response. All patients who underwent induction therapy and surgery alone were negative for CTCs in peripheral blood. In the induction therapy group, 4 patients showing pathological CR were negative for CTCs in pulmonary venous blood (pvCTCs) and 5 showing major/minor response were positive (mean, 57.8 cells). The numbers of CTCs in patients showing major/minor response were significantly higher than those in patients showing pathological CR (p = 0.012, Mann-Whitney U test). All 6 patients undergoing surgery alone were positive for pvCTCs (mean, 207.5 cells), showing a significant difference from those undergoing induction therapy (p = 0.038).
  
  
  CONCLUSIONS
  The existence of CTCs in pulmonary venous blood reflects pathological non-CR, and therapeutic pathological response may be predicted by pvCTC measurement.
authors.affiliation: Department of general thoracic, breast and Endocrinological surgery, Faculty of medicine Kagawa University, Kagawa, Japan. starumi@med.kagawa-u.ac.jp
authors.forename: Shintaro
authors.initials: S
authors.lastname: Tarumi
authors.forename: Masashi
authors.initials: M
authors.lastname: Gotoh
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Kasai
authors.forename: Natsumi
authors.initials: N
authors.lastname: Matsuura
authors.forename: Masaya
authors.initials: M
authors.lastname: Okuda
authors.forename: Tetsuhiko
authors.initials: T
authors.lastname: Go
authors.forename: Shinya
authors.initials: S
authors.lastname: Ishikawa
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Yokomise
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000378:metabolism* / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000378:metabolism*; D018709:Statistics, Nonparametric; D013908:Thoracotomy; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents