Carbon-ion radiotherapy for octogenarians with locally advanced non-small-cell lung cancer

Abstract

Purpose The clinical significance of carbon-ion radiotherapy (CIRT) for octogenarians with locally advanced non-small-cell lung cancer (LA-NSCLC) remains unclear. We aimed to evaluate the clinical outcomes of CIRT alone for octogenarians with LA-NSCLC. Materials and methods We evaluated 32 patients who underwent CIRT alone between 1997 and 2015. The median age was 82.0 years (range, 80–88 years). In terms of clinical stage (UICC 7th edition), 7 (21.9%), 10 (31.3%), 11 (34.4%), and 4 (12.5%) patients had stage IIA, IIB, IIIA, and ΙΙΙB disease, respectively. The median CIRT dose was 72.0 Gy (relative biological effectiveness), and the median follow-up period was 33.1 months. Results All patients successfully completed CIRT. Regarding grade ≥ 2 toxicities, 1 (3.1%), 3 (9.4%), and 4 (0.7%) patients developed grade 3 radiation pneumonitis, grade 2 radiation pneumonitis, and grade 2 dermatitis, respectively. No grade ≥ 4 toxicities were observed. The 2 year LC, PFS, and OS rates were 83.5%, 46.7%, and 68.0%, respectively. Conclusion CIRT alone is safe and effective for octogenarians with LA-NSCLC.

Research Progress of Heavy Ion Radiotherapy for Non-Small-Cell Lung Cancer

“…The two-year local control rate, progression-free survival rate, and overall survival rate were 83.5%, 46.7%, and 68.0%, respectively. This study demonstrates that CIRT is safe and effective in NSCLC patients over 80 years of age [62]. Many elderly patients with NSCLC also suffer from other diseases such as chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD) [63], and cardiovascular disease (CVD).…”

Value of carbon-ion radiotherapy for early stage non-small cell lung cancer

“…In terms of AEs, no patient suffered grade 4 RP. Grade 3 RP and Grade 2 RP were recorded in 1 patient (3.1%), and 3 patients (9.4%) respectively [50] . The incidence of RP in geriatric patients was lower than the one recorded under photon beam radiotherapy [40] , [51] , [52] , [53] .…”

Long-term outcomes of high-dose carbon-ion radiotherapy for central non-small cell lung cancer: a single-centre, retrospective study.

“…Carbon-ion radiation therapy (CIRT) is a radiation therapy (RT) modality characterized by excellent dose concentration, greater biological effectiveness, and advantageous Bragg peak effect [18,19]. We have been exploring CIRT for lung tumors since 1994 and have developed highdose CIRT for localized NSCLC, nding better results relative to photon SBRT [20][21][22][23]. Currently, the protocol of 50 Gy (relative biological effectiveness [RBE]) in a single fraction (fr) is employed for peripheral, early-stage NSCLC and provides tumor control that is comparable to SBRT but with an extremely high safety pro le [24,25].…”

“…Abbreviations. OAR, organ at risk; GTV, gloss target volume; V5(20), percentage of the volume of an organ receiving 5(20) Gy; MLD, mean lung dose; RBE, relative biological effectiveness; PBT, proximal bronchial tree.For the lungs, the lung V5 and V20 were 15.50 (10.16-24.14) % and 10.38 (3.66-18.24) %, respectively. The MLD was 5.64 (2.58-10.93) Gy (RBE).…”