title: Spleen Volume Variation in Patients with Locally Advanced Non-Small Cell Lung Cancer Receiving Platinum-Based Chemo-Radiotherapy.
abstract: There is renewed interest in the immune regulatory role of the spleen in oncology. To date, very few studies have examined macroscopic variations of splenic volume in the setting of cancer, prior to or during therapy, especially in humans. Changes in splenic volume may be associated with changes in splenic function. The purpose of this study was to investigate variations in spleen volume in NSCLC patients during chemo-radiotherapy. Sixty patients with stage I-IIIB NSCLC underwent radiotherapy (60 Gy/30 fractions) for six weeks with concomitant carboplatin/paclitaxel (Ca/P; n = 32) or cisplatin/etoposide (Ci/E; n = 28). A baseline PET/CT scan was performed within 2 weeks prior to treatment and during Weeks 2 and 4 of chemo-radiotherapy. Spleen volume was measured by contouring all CT slices. Significant macroscopic changes in splenic volume occurred early after the commencement of treatment. A significant decrease in spleen volume was observed for 66% of Ca/P and 79% of Ci/E patients between baseline and Week 2. Spleen volume was decreased by 14.2% for Ca/P (p<0.001) and 19.3% for Ci/E (p<0.001) patients. By Week 4, spleen volume was still significantly decreased for Ca/P patients compared to baseline, while for Ci/E patients, spleen volume returned to above baseline levels. This is the first report demonstrating macroscopic changes in the spleen in NSCLC patients undergoing radical chemo-radiotherapy that can be visualized by non-invasive imaging.
authors.affiliation: Tumour Microenvironment Laboratory, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia.
authors.forename: Shu Wen
authors.initials: SW
authors.lastname: Wen
authors.affiliation: Department of Radiation Oncology, Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia.|The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia.|Department of Medical Imaging and Radiation Sciences, Monash University, Clayton, VIC, Australia.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Everitt
authors.affiliation: IBM Research-Australia, Carlton, VIC, Australia.|Department of Computing and Information Systems, The University of Melbourne, Parkville, VIC, Australia.
authors.forename: Justin
authors.initials: J
authors.lastname: Bedő
authors.affiliation: Centre for Molecular Imaging, Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia.
authors.forename: Marine
authors.initials: M
authors.lastname: Chabrot
authors.affiliation: Department of Radiation Oncology, Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia.|The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia.
authors.forename: David L
authors.initials: DL
authors.lastname: Ball
authors.affiliation: The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia.|Medical Oncology, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Solomon
authors.affiliation: Department of Radiation Oncology, Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia.|The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: MacManus
authors.affiliation: The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia.|Centre for Molecular Imaging, Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia.
authors.forename: Rodney J
authors.initials: RJ
authors.lastname: Hicks
authors.affiliation: Tumour Microenvironment Laboratory, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia.|School of Medicine, University of Queensland, Brisbane, QLD, Australia.
authors.forename: Andreas
authors.initials: A
authors.lastname: Möller
authors.affiliation: Centre for Molecular Imaging, Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia.|Department of Medical Imaging, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
authors.forename: Antoine
authors.initials: A
authors.lastname: Leimgruber
mesh_terms: D000368:Aged; D016190:Carboplatin / Q000008:administration & dosage; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000008:administration & dosage; D049268:Positron-Emission Tomography; D011379:Prognosis; D011859:Radiography; D013154:Spleen / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology*
chemical_list: D005047:Etoposide; D016190:Carboplatin; D017239:Paclitaxel