ArticlePhysics and imaging in radiation oncology2026
Longitudinal computed tomography body composition changes in patients receiving curative radiotherapy for non-small cell lung cancer.
Article in Physics and imaging in radiation oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and purpose: To determine whether longitudinal changes on routine thoracic computed tomography (CT) predict overall survival (OS) in non-small cell lung cancer (NSCLC) after curative radiotherapy and identify dose predictors of adverse tissue changes. Materials and methods: We performed a retrospective, single-centre study of 231 stage I-IV NSCLC patients who had at least two follow-up scans. In total, 2708 CT scans were analysed (median follow-up, 22 months; range, 1-97). Automated segmentation quantified left ventricular (LV) myocardium, L1 skeletal muscle (SKM) and fat volumes. For each tissue, baseline-normalised trajectories were used to compute monthly rates of change ("velocity"), and non-linear associations with OS were evaluated. Logistic regression identified dose metrics associated with adverse tissue change. Results: SKM velocity stratified OS (C-index, 0.70): SKM loss < -0.4%/month vs ≥ -0.4%/month, HR 4.41 (95% CI 2.46-7.91, Conclusion: Longitudinal CT biomarkers, particularly SKM loss rate and deviation in LV-myocardial mass, are associated with OS after curative NSCLC irradiation. These findings require validation in multicentre studies with more complete clinical information.
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