Curative treatment of Stage I non-small-cell lung cancer with carbon ion beams using a hypofractionated regimen.
OBJECTIVE
A phase I/II study on carbon ion radiotherapy for Stage I non-small-cell lung cancer (NSCLC) was first conducted between 1994 and 1999 and determined the optimal dose. Second, a Phase II study using the optimal dose was performed. The purpose of the present study was to clarify the local control and 5-year survival rates.


METHODS
Between April 1999 and December 2000, 50 patients with 51 primary lesions were treated. Using a fixed dose of 72 GyE in nine fractions over 3 weeks, the primary tumors were irradiated with carbon ion beams alone. The average age of the patients was 74.5 years. Thirty-three (66%) of these were medically inoperable. Local control and survival were determined by using the Kaplan-Meier method and the data were statistically processed by using the log-rank test.


RESULTS
All patients were observed for a minimum of 5 years or until death with a median follow-up time of 59.2 months (range, 6.0-83.0 months). The local control rate for all patients was 94.7%. The patients' 5-year cause-specific survival rate was 75.7% (IA: 89.4; IB: 55.1), and overall survival 50.0% (IA: 55.2; IB: 42.9). No toxic reactions in the lung greater than Grade 3 were detected.


CONCLUSIONS
Carbon ion radiotherapy, a new treatment modality with superior benefits in terms of quality of life and activity of daily living, has been proven as a valid alternative to surgery for Stage I NSCLC and to offer particular benefits, especially for elderly and inoperable patients.
Miyamoto
Tadaaki
T
Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences (NIRS), Chiba, Japan. t_miyamt@nirs.go.jp
Baba
Masayuki
M
Yamamoto
Naoyoshi
N
Koto
Masashi
M
Sugawara
Toshiyuki
T
Yashiro
Tomoyasu
T
Kadono
Kennoshuke
K
Ezawa
Hidefumi
H
Tsujii
Hirohiko
H
Mizoe
Jun-Etsu
JE
Yoshikawa
Kyosan
K
Kandatsu
Susumu
S
Fujisawa
Takehiko
T
D000230:Adenocarcinoma / Q000401:mortality / Q000532:radiotherapy; D000368:Aged; D000369:Aged, 80 and over; D002250:Carbon Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000532:radiotherapy*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality
D002250:Carbon Radioisotopes