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@ARTICLE{Trommer:299518,
      author       = {S. Trommer and J. A. Müller and M. Oertel and F. Ehret$^*$
                      and S. Roohani$^*$ and H. M. Ha and Q. N. Ha and K. Hering
                      and F. Nägler and T. Lange and M. Mäurer and T. Weissmann
                      and F. Putz and M. Trommer and C. Baues and S. Dobiasch$^*$
                      and M. Waltenberger$^*$ and T. Skripcak$^*$ and D.
                      Vordermark and D. Medenwald},
      title        = {{T}umor volume change at radiation boost planning to
                      estimate the response to chemoradiotherapy in stage {III}
                      unresectable {NSCLC} ({TORCH}): a multicenter retrospective
                      observational study.},
      journal      = {Strahlentherapie und Onkologie},
      volume       = {nn},
      issn         = {0179-7158},
      address      = {Heidelberg},
      publisher    = {Springer Medizin},
      reportid     = {DKFZ-2025-00476},
      pages        = {nn},
      year         = {2025},
      note         = {epub},
      abstract     = {Progression-free (PFS) and overall survival (OS) in UICC
                      stage III non-small cell lung cancer (NSCLC) after
                      definitive concurrent chemoradiotherapy (CRT) can be
                      increased with consolidating immunotherapy. Recent studies
                      have shown a strong predictive value of gross tumor volume
                      (GTV) changes during CRT on OS. The TORCH trial investigated
                      the prognostic impact of GTV changes during CRT as a
                      predictor for a response to immunotherapy.This retrospective
                      non-interventional observational multicenter trial included
                      n = 203 patients from 10 German university centers for
                      radiation oncology with confirmed inoperable NSCLC in UICC
                      stage III A-C. Patients had received CRT between 2015 and
                      2023 as a curative-intent treatment approach. Patient and
                      tumor characteristics were collected anonymously via
                      electronic case report forms. Initial GTVs before CRT
                      (initial planning CT, GTV1) and at 40-50 Gy (re-planning CT
                      for radiation boost, GTV2) were delineated. Absolute and
                      relative GTV changes before/during CRT were correlated with
                      OS to predict the response to CRT with sequential
                      immunotherapy. Hazard ratios (HR) of survival analyses were
                      estimated using adjusted Cox regression models.The mean GTV1
                      before radiation therapy (RT) was 145.29 ml with the 25th,
                      50th, and 75th percentiles being 61.36 ml, 145.29 ml, and
                      204.93 ml, respectively. Before initiation of the radiation
                      boost, the mean GTV2 was 99.58 ml, with the 25th, 50th, and
                      75th percentiles at 32.93 ml, 70.45 ml, and 126.85 ml. The
                      HR for the impact of GTV1 on survival was 0.99 per ml
                      $(95\%$ confidence interval [CI] 0.99-1.00; p = 0.49). For
                      the absolute volume change between GTV1 and GTV2, the HR was
                      1.004 per ml $(95\%$ CI 0.997-1.011; p = 0.26). In a
                      subgroup analysis of patients who were treated with
                      durvalumab, absolute volume changes between GTV1 and GTV2
                      were associated with longer OS (HR = 0.955 per ml; $95\%$ CI
                      0.916-0.996; p = 0.03). Overall, durvalumab treatment was
                      positively associated with OS, demonstrating an HR of 0.454
                      $(95\%$ CI 0.209-0.990; p = 0.047).Pretreatment GTV and
                      absolute GTV volume changes did not significantly correlate
                      with OS. However, the absolute volume change between the
                      pretreatment and replanning GTV was associated with longer
                      OS in patients treated with durvalumab. Histological
                      subtype, grading, UICC stage, age at onset, pulmonary
                      comorbidities, and smoking status had no significant
                      association with OS. Durvalumab treatment was associated
                      with improved OS.},
      keywords     = {Durvalumab (Other) / Gross tumor volume (Other) /
                      Immunotherapy (Other) / Non-small cell lung cancer (Other) /
                      Stage III lung cancer (Other)},
      cin          = {BE01 / MU01 / DD01},
      ddc          = {610},
      cid          = {I:(DE-He78)BE01-20160331 / I:(DE-He78)MU01-20160331 /
                      I:(DE-He78)DD01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40029351},
      doi          = {10.1007/s00066-025-02374-3},
      url          = {https://inrepo02.dkfz.de/record/299518},
}