High-dose proton beam therapy for Stage I non-small-cell lung cancer.
OBJECTIVE
To evaluate retrospectively the safety and efficacy of high-dose proton beam therapy (PBT) for Stage I non-small-cell lung cancer (NSCLC).


METHODS
Between 1999 and 2003, 37 patients were treated in our institution. The indications for PBT were pathologically proven NSCLC, clinical Stage I, tumor size < or =5 cm, medically inoperable or refusal of surgery, and written informed consent. A total dose of 70-94 Gy(E) was delivered in 20 fractions (3.5-4.9 Gy(E) per fraction).


RESULTS
Patient characteristics (number of patients) were as follows: Stage IA/IB, 17 of 20; medically inoperable/refusal of surgery, 23/14; total dose 70/80/88/94 Gy(E), 3/17/16/1. With a median follow-up period of 24 months, the 2-year local progression-free and overall survival rates were 80% and 84%, respectively. The 2-year locoregional relapse-free survival rates in Stage IA and Stage IB were 79% and 60%, respectively. No serious acute toxicity was observed. Late Grades 2 and 3 pulmonary toxicities were observed in 3 patients each. Of these 6 patients, 5 had Stage IB disease.


CONCLUSIONS
Proton beam therapy is a promising treatment modality for Stage I NSCLC, though locoregional relapse and late pulmonary toxicities in Stage IB patients were substantial. Further investigation of PBT for Stage I NSCLC is warranted.
Nihei
Keiji
K
Radiation Oncology Division, National Cancer Center Hospital East, Kashiwa, Chiba, Japan. knihei@east.ncc.go.jp
Ogino
Takashi
T
Ishikura
Satoshi
S
Nishimura
Hideki
H
D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D061766:Proton Therapy; D017564:Radiation Pneumonitis / Q000209:etiology; D012189:Retrospective Studies; D015996:Survival Rate; D011522:Protons
D011522:Protons