High-dose proton beam therapy for stage I non-small cell lung cancer: Clinical outcomes and prognostic factors

Makita, Chiyoko; Nakamura, Tatsuya; Takada, Akinori; Takayama, Kohei; Suzuki, Motohisa; Azami, Yusuke; Katō, Takahiro; Tsukiyama, Iwao; Hareyama, Masato; Kikuchi, Yasuhiro; Daimon, Takashi; Hata, Masaharu; Inoue, Tomio; Fuwa, Nobukazu

doi:10.3109/0284186x.2014.948060

Cited by 27 publications

(35 citation statements)

References 26 publications

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“…[11][12][13][14][15] Hypofractionated, high-dose PBT has been used to treat inoperable patients or patients who refuse to undergo surgery in Japan, and previous single-institute studies have demonstrated promising results of PBT for stage I NSCLC. [18][19][20] The present study is the first multiinstitutional study to evaluate the feasibility and efficacy of PBT for stage I NSCLC in a large number of patients. These results may therefore represent the outcomes of PBT Abbreviations: LPF Z local progression-free rate; OS Z overall survival; PFS Z progression-free survival; PS Z performance status.…”

Section: Discussionmentioning

confidence: 99%

“…In recent institutional retrospective studies of patients with stage I NSCLC treated with PBT, the 3-year OS and LC rates ranged from 75% to 81% and from 81% to 96%, respectively; grade 3 RP was observed in 1.3% to 1.7% of patients. [18][19][20] Whether PBT improves survival and LC while also decreasing the incidence of radiation-induced toxicities compared with SBRT in patients with stage I NSCLC remains unclear. Only one randomized phase 2 study has compared SBRT and PBT for early-stage NSCLC; this study ended prematurely because of poor accrual.…”

Section: Introductionmentioning

confidence: 99%

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Proton Beam Therapy for Histologically or Clinically Diagnosed Stage I Non-Small Cell Lung Cancer (NSCLC): The First Nationwide Retrospective Study in Japan

Ohnishi

Nakamura

Harada

et al. 2020

International Journal of Radiation Oncology*Biology*Physics

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Purpose: To investigate the efficacy and safety of proton beam therapy (PBT) for the treatment of stage I non-small cell lung cancer (NSCLC). Methods and Materials: Six hundred sixty-nine patients with 682 tumors histologically or clinically diagnosed stage I NSCLC according to the seventh edition of Union for International Cancer Control who received passive-scattering PBT from April 2004 and December 2013 in Japan were retrospectively reviewed to analyze survival, local control, and toxicities. Results: Of 669 patients, 486 (72.6%) were men, with a median age of 76 years (range, 42-94 years). NSCLC was histologically confirmed in 440 patients (65.7%). Clinical T stages included T1a (n Z 265; 38.9%), T1b (n Z 216; 31.7%), and T2a (n Z 201; 29.4%). The total irradiation doses of PBT ranged from 74.4 to 131.3 biological effective dose GyE (median, 109.6

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Proton Beam Therapy for Histologically or Clinically Diagnosed Stage I Non-Small Cell Lung Cancer (NSCLC): The First Nationwide Retrospective Study in Japan

Ohnishi

Nakamura

Harada

et al. 2020

International Journal of Radiation Oncology*Biology*Physics

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“…The OS, PFS and LC for the entire cohort were 81.3%, 73.4%, and 96%, respectively, at 3 years, with no grade 4 or 5 toxicities reported, and grade 3 toxicities limited to two patients; one with dermatitis and the other with pneumonitis. 54 …”

Section: Proton Therapy In Early Stage Nsclcmentioning

confidence: 99%

Advances in proton therapy in lung cancer

Vyfhuis

Onyeuku

Diwanji

et al. 2018

Ther Adv Respir Dis

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Lung cancer remains the leading cause of cancer deaths in the United States (US) and worldwide. Radiation therapy is a mainstay in the treatment of locally advanced non-small cell lung cancer (NSCLC) and serves as an excellent alternative for early stage patients who are medically inoperable or who decline surgery. Proton therapy has been shown to offer a significant dosimetric advantage in NSCLC patients over photon therapy, with a decrease in dose to vital organs at risk (OARs) including the heart, lungs and esophagus. This in turn, can lead to a decrease in acute and late toxicities in a population already predisposed to lung and cardiac injury. Here, we present a review on proton treatment techniques, studies, clinical outcomes and toxicities associated with treating both early stage and locally advanced NSCLC.

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“…In clinical studies, Japanese centers reported promising local control and feasibility for central tumors using a more fractionated schedule PBT. 26 , 27 Makita et al 27 reported that they treated 24 central tumors with 80 Gy (RBE) in 25 fractions, and no one experienced late grade 3 or severe toxicities. These promising results have some limitations in that these are retrospective studies with a small number of patients.…”

Section: Introductionmentioning

confidence: 99%

Proton beam therapy in non-small cell lung cancer: state of the art

Harada

Murayama

2017

LCTT

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This review summarizes the past and present status of proton beam therapy (PBT) for lung cancer. PBT has a unique characteristic called the Bragg peak that enables a reduction in the dose of normal tissue around the tumor, but is sensitive to the uncertainties of density changes. The heterogeneity in electron density for thoracic lesions, such as those in the lung and mediastinum, and tumor movement according to respiration necessitates respiratory management for PBT to be applied in lung cancer patients. There are two types of PBT – a passively scattered approach and a scanning approach. Typically, a passively scattered approach is more robust for respiratory movement and a scanning approach could result in a more conformal dose distribution even when the tumor shape is complex. Large tumors of centrally located lung cancer may be more suitably irradiated than with intensity-modulated radiotherapy (IMRT) or stereotactic body radiotherapy (SBRT). For a locally advanced lung cancer, PBT can spare the lung and heart more than photon IMRT. However, no randomized controlled trial has reported differences between PBT and IMRT or SBRT for early-stage and locally advanced lung cancers. Therefore, a well-designed controlled trial is warranted.

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High-dose proton beam therapy for stage I non-small cell lung cancer: Clinical outcomes and prognostic factors

Cited by 27 publications

References 26 publications

Proton Beam Therapy for Histologically or Clinically Diagnosed Stage I Non-Small Cell Lung Cancer (NSCLC): The First Nationwide Retrospective Study in Japan

Proton Beam Therapy for Histologically or Clinically Diagnosed Stage I Non-Small Cell Lung Cancer (NSCLC): The First Nationwide Retrospective Study in Japan

Advances in proton therapy in lung cancer

Proton beam therapy in non-small cell lung cancer: state of the art

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