A Phase I Study of Hypofractionated Carbon-ion Radiotherapy for Stage III Non-small Cell Lung Cancer

Saitoh, Jun‐ichi; Shirai, Katsuyuki; Abe, Takanori; Kubo, Nobuteru; Ebara, Takeshi; Ohno, Tatsuya; Minato, Koichi; Saito, Ryusei; Yamada, Masanobu; Nakano, Takashi

doi:10.21873/anticanres.12298

Cited by 13 publications

(7 citation statements)

References 22 publications

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“…Radiotherapy alone or in combination with systemic therapies is commonly used for treating locally advanced lung cancers (2). As the prognosis of these patients is often limited, considerable research is carried out to improve their outcomes (9)(10)(11)(12)(13). If radiotherapy is administered, high doses are often required, particularly if the treatment approach is considered curative.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Characteristics of Symptomatic Pneumonitis After Radiotherapy of Patients With Locally Advanced Lung Cancer

et al. 2019

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Background/Aim: Radiotherapy of locally advanced lung cancer often requires high doses potentially leading to pneumonitis. This study evaluated the rate of symptomatic pneumonitis and characteristics in these patients. Patients and Methods: This study included 278 patients irradiated for locally advanced lung cancer between 2016 and 2019. In patients experiencing symptomatic pneumonitis, patient and treatment characteristics were analyzed. Results: Pneumonitis was diagnosed in 21 patients (7.6%) after a median of 9 (1-23) weeks. Ipsilateral lungs received mean doses >13 Gy in 21 (100%) and >20 Gy in 15 patients (71.4%). Seventeen patients (81.0%) received chemotherapy and/or immunotherapy, 12 (57.1%) had significant cardiovascular disease (all 21 patients had risk factors), 11 (52.4%) were heavy smokers (≥40 pack years), 7 (33.3%) were aged ≥74 years, 5 (23.8%) had chronic inflammatory disease and 4 (19.0%) had previous tumors. Conclusion: Overall pneumonitis rate was 7.6%. Frequent characteristics included high mean lung doses, systemic treatment, cardiovascular disease (and risk factors), heavy smoking, older age, chronic inflammatory disease and history of a previous tumor.

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Section: Discussionmentioning

confidence: 99%

Prevalence and Characteristics of Symptomatic Pneumonitis After Radiotherapy of Patients With Locally Advanced Lung Cancer

et al. 2019

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“…Because local control (LC) is an important factor associated with OS after CCRT for LA-NSCLC, 7,8 great efforts have been made to improve LC, including the use of radiation dose-escalation. [7][8][9][10] On the other hand, the combination of radiotherapy and immune checkpoint inhibitors in lung cancer patients has attracted increasing interest regarding improvements in outcomes, including local control. 11,12 Based on this background, in the study reported here we evaluated the effect of the durvalumab on local control in comparison with the clinical result of patients treated with CCRT alone at our institution.…”

Section: Introductionmentioning

confidence: 99%

Effect of durvalumab on local control after concurrent chemoradiotherapy for locally advanced non‐small cell lung cancer in comparison with chemoradiotherapy alone

et al. 2020

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Background: Durvalumab after concurrent chemoradiotherapy (CCRT) for locally advanced non-small cell lung cancer (LA-NSCLC) has been found to significantly improve overall survival (OS). However, the effect of durvalumab on local control remains unclear. Here, we evaluated the effect of the durvalumab on local control in comparison with the clinical result of patients treated with CCRT alone. Methods: A total of 120 LA-NSCLC patients including 76 patients with CCRT alone and 44 patients with CCRT followed by durvalumab were analyzed. Baseline patient characteristics of CCRT alone cohort and durvalumab cohort were compared with student's t test or Mann-Whitney U test for continuous variables and with chi-squared test for categorical variables. Local control (LC), progression free survival (PFS) and OS rates were estimated using the Kaplan-Meier method and compared with the log-rank test. Results: There were 19 patients with stage II disease and 101 patients with stage III disease. Age, sex, histopathological type, T classification, N classification, clinical stage, tumor volume and dose fractionation schedule were not significantly different between the CCRT alone and durvalumab cohorts. The one-year LC rate was significantly higher in the durvalumab cohort (86%) compared with the CCRT alone cohort (62%) (P = 0.005), whereas no significant difference was observed in either PFS (P = 0.864) or OS (P = 0.443) between the CCRT and durvalumab cohorts. Conclusions: The one-year LC rate was significantly higher in the durvalumab cohort compared with the CCRT alone cohort. Although the follow-up period was too short to draw definitive conclusions, the study revealed that durvalumab might have a significant effect on LC.

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“…At the Gunma University Heavy Ion Medical Center, carbon-ion (C-ion) RT was initiated in 2010 for treating various cancers, including head and neck cancer (7), non-small cell lung cancer (8), and cancers of the liver (9–11), prostate, and uterine cervix (12). Bone and soft tissue sarcomas have also been treated.…”

Section: Introductionmentioning

confidence: 99%

Prospective Observational Study of High-Dose Carbon-Ion Radiotherapy for Pelvic Recurrence of Rectal Cancer (GUNMA 0801)

et al. 2019

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Background and purpose: Favorable clinical outcomes of carbon-ion radiotherapy for pelvic recurrence of rectal cancer have been described by previous prospective phase I/II and II studies; however, these studies were performed at a single institution. Therefore, we conducted a prospective observational study aimed at exploring whether carbon-ion radiotherapy for post-operative pelvic recurrence of rectal cancer provides a less invasive local treatment strategy with higher cure rates than other anticancer treatments. Materials and methods: Patients (1) with pelvic recurrence of rectal cancer, as confirmed by histology or diagnostic imaging; (2) without distant metastasis; (3) who had undergone curative resection of their primary disease and regional lymph nodes, without gross or microscopic residual disease; and (4) with radiographically measurable tumors were included in this study. The total carbon-ion radiotherapy dose for all patients was 73.6 Gy [relative biological effectiveness (RBE)] administered in 16 fractions once daily for 4 days a week (Tuesday to Friday). Results: A total of 28 patients were enrolled between October 2011 and July 2017. The median follow-up duration was 38.9 months. The 3-year overall survival, local control, and progression-free survival rates were 92, 86, and 31%, respectively. At the time of the analysis, 4 patients had local recurrence, and 7 had died of rectal cancer. None of the patients developed grade 3 or higher acute toxicities. Late toxicities occurred in 2 and 7 patients who developed grade 3 pelvic infection and grade 2 peripheral neuropathy, respectively. Conclusion: Carbon-ion radiotherapy for pelvic recurrence of rectal cancer showed favorable clinical outcomes and is a highly curative and less invasive local treatment.

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A Phase I Study of Hypofractionated Carbon-ion Radiotherapy for Stage III Non-small Cell Lung Cancer

Abstract: Hypofractionated C-ion RT of patients with stage III NSCLC was feasible and well tolerated. Although the number of patients in this study was small, the results support further investigations to confirm the long-term therapeutic efficacy of this treatment.

Cited by 13 publications

References 22 publications

Prevalence and Characteristics of Symptomatic Pneumonitis After Radiotherapy of Patients With Locally Advanced Lung Cancer

Prevalence and Characteristics of Symptomatic Pneumonitis After Radiotherapy of Patients With Locally Advanced Lung Cancer

Effect of durvalumab on local control after concurrent chemoradiotherapy for locally advanced non‐small cell lung cancer in comparison with chemoradiotherapy alone

Prospective Observational Study of High-Dose Carbon-Ion Radiotherapy for Pelvic Recurrence of Rectal Cancer (GUNMA 0801)

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