Clinical evaluation of proton radiotherapy for non-small-cell lung cancer.
OBJECTIVE
To evaluate the clinical results of proton radiotherapy for patients with non-small-cell lung cancer (NSCLC).


METHODS
Between 1983 and 2000, 51 NSCLC patients were treated with proton beams at the University of Tsukuba. There were 28 patients in Stage I, 9 in Stage II, 8 in Stage III, 1 in Stage IV, and 5 with recurrent disease. Thirty-three patients had squamous cell carcinoma, 17 had adenocarcinoma, and 1 had large-cell carcinoma. Median fraction and total doses given were 3.0 Gy (range 2.0-6.0 Gy), and 76.0 Gy (range 49.0-93.0 Gy), respectively.


RESULTS
The 5-year overall survival rate was 29% for all patients, 70% for 9 Stage IA patients, and 16% for 19 Stage IB patients, respectively (IA vs. IB: p < 0.05). The 5-year in-field local control rate was higher in patients with Stage IA (89%) when compared with those with Stage IB (39%). Forty-seven patients (92%) experienced acute lung toxicity of Grade 1 or less; 3 had Grade 2, 1 had Grade 3, and none experienced Grade 4 or higher. Patients in the present series showed very little late toxicity.


CONCLUSIONS
Proton therapy is a very safe and effective treatment for patients with NSCLC, especially for those with early stages. The relative merit of proton therapy in comparison with stereotactic photon radiotherapy or three-dimensional conformal photon radiotherapy remains to be defined through future clinical trials.
Shioyama
Yoshiyuki
Y
Department of Radiation Oncology, The University Hospital, Tsukuba, Japan.
Tokuuye
Koichi
K
Okumura
Toshiyuki
T
Kagei
Kenji
K
Sugahara
Shinji
S
Ohara
Kiyoshi
K
Akine
Yasuyuki
Y
Ishikawa
Shigemi
S
Satoh
Hiroaki
H
Sekizawa
Kiyohisa
K
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018287:Carcinoma, Large Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D015993:Life Tables; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D061766:Proton Therapy; D020266:Radiotherapy, Conformal; D011882:Radiotherapy, High-Energy; D016019:Survival Analysis; D016896:Treatment Outcome; D011522:Protons
D011522:Protons