Spleen Volume Variation in Patients with Locally Advanced Non-Small Cell Lung Cancer Receiving Platinum-Based Chemo-Radiotherapy

Shu Wen Wen; Sarah J Everitt; Justin Bedő; Marine Chabrot; David L Ball; Benjamin Solomon; Michael MacManus; Rodney J Hicks; Andreas Möller; Antoine Leimgruber

doi:10.1371/journal.pone.0142608

Spleen Volume Variation in Patients with Locally Advanced Non-Small Cell Lung Cancer Receiving Platinum-Based Chemo-Radiotherapy

PLoS One. 2015 Nov 24;10(11):e0142608. doi: 10.1371/journal.pone.0142608. eCollection 2015.

Authors

Shu Wen Wen¹, Sarah J Everitt^{2

3

4}, Justin Bedő^{5

6}, Marine Chabrot⁷, David L Ball^{2

3}, Benjamin Solomon^{3

8}, Michael MacManus^{2

3}, Rodney J Hicks^{3

7}, Andreas Möller^{1

9}, Antoine Leimgruber^{7

10}

Affiliations

¹ Tumour Microenvironment Laboratory, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia.
² Department of Radiation Oncology, Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia.
³ The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia.
⁴ Department of Medical Imaging and Radiation Sciences, Monash University, Clayton, VIC, Australia.
⁵ IBM Research-Australia, Carlton, VIC, Australia.
⁶ Department of Computing and Information Systems, The University of Melbourne, Parkville, VIC, Australia.
⁷ Centre for Molecular Imaging, Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia.
⁸ Medical Oncology, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia.
⁹ School of Medicine, University of Queensland, Brisbane, QLD, Australia.
¹⁰ Department of Medical Imaging, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.

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.

Publication types

Clinical Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Carboplatin / administration & dosage
Carcinoma, Non-Small-Cell Lung / diagnostic imaging*
Carcinoma, Non-Small-Cell Lung / drug therapy*
Carcinoma, Non-Small-Cell Lung / pathology
Carcinoma, Non-Small-Cell Lung / radiotherapy
Etoposide / administration & dosage
Female
Humans
Male
Middle Aged
Neoplasm Staging
Paclitaxel / administration & dosage
Positron-Emission Tomography
Prognosis
Radiography
Spleen / diagnostic imaging
Spleen / drug effects*
Spleen / pathology*

Substances

Etoposide
Carboplatin
Paclitaxel

Grants and funding

AL, AM and SE are supported by The CASS Foundation (SM/12/4249/RMR:DR; www.cassfoundation.org). AM and AL are supported by the National Health and Medical Research Council (www.nhmrc.gov.au) project grant APP106851, Cancer Council Queensland grant (APP1045260; www.cancerqld.org.au), and a National Breast Cancer Foundation Australia grant (NC-13-26; www.nbcf.org.au/) and fellowship to AM (ECF-11-09). SE is supported by NHMRC (www.nhmrc.gov.au) grant APP1003895. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The funder IBM Australia provided support in the form of salaries for Dr Justin Bedo, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Dr Bedo also holds an adjunct position at The University of Melbourne, Australia, as indicated in the manuscript.