Carbon ion radiotherapy for stage I non-small cell lung cancer using a regimen of four fractions during 1 week.
BACKGROUND
A phase I/II study was first conducted for the treatment of stage I non-small cell lung cancer (NSCLC) from 1994 to 1999 to determine the optimal dose. On the basis on the results, a phase II study using a regimen of four fractions during 1 week was performed. The purpose of the present study was to determine the local control and 5-year survival rates.


METHODS
From December 2000 to November 2003, 79 patients with 80 primary lesions were treated. Using a fixed dose of 52.8 GyE for stage IA NSCLC and 60.0 GyE for stage IB NSCLC in four fractions during 1 week, the primary tumors were irradiated with carbon beams alone. The average age of the patients was 74.8 years. Sixty-two (78.5%) of these patients were medically inoperable. Local control and survival were determined using the Kaplan-Meier method. The data were statistically processed using the log-rank test.


RESULTS
All patients were observed for a minimum of 3 years or until death, with a median follow-up time of 38.6 months, ranging from 2.5 to 72.2 months. The local control rate for all patients was 90% (T1: 98%, T2: 80%). The patients' 5-year lung cancer-specific survival rate was 68% (IA: 87%, IB: 42%). The overall survival was 45% (IA: 62%, IB: 25%). Half of the deaths were attributable to intercurrent diseases. No toxic reactions in the lung greater than grade 3 were detected.


CONCLUSIONS
Carbon ion beam radiotherapy with a regimen of four fractions during 1 week 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, Chiba, Japan. t_miyamt@nirs.go.jp
Baba
Masayuki
M
Sugane
Toshio
T
Nakajima
Mio
M
Yashiro
Tomoyasu
T
Kagei
Kennji
K
Hirasawa
Naoki
N
Sugawara
Toshiyuki
T
Yamamoto
Naoyoshi
N
Koto
Masashi
M
Ezawa
Hidefumi
H
Kadono
Kennoshuke
K
Tsujii
Hirohiko
H
Mizoe
Jun-etsu
JE
Yoshikawa
Kyosan
K
Kandatsu
Susumu
S
Fujisawa
Takehiko
T
D000230:Adenocarcinoma / Q000532:radiotherapy / Q000556:secondary; D000368:Aged; D000369:Aged, 80 and over; D002250:Carbon Radioisotopes / Q000627:therapeutic use*; D018196:Carcinoma, Adenosquamous / Q000532:radiotherapy / Q000556:secondary; D018287:Carcinoma, Large Cell / Q000532:radiotherapy / Q000556:secondary; D002289:Carcinoma, Non-Small-Cell Lung / Q000532:radiotherapy* / Q000556:secondary; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000556:secondary; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology / Q000473:pathology; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D015996:Survival Rate; D016896:Treatment Outcome
D002250:Carbon Radioisotopes