title: Long-term outcome of proton therapy and carbon-ion therapy for large (T2a-T2bN0M0) non-small-cell lung cancer.
abstract: BACKGROUND
  : Although many reports have shown the safety and efficacy of stereotactic body radiotherapy (SBRT) for T1N0M0 non-small-cell lung cancer (NSCLC), it is rather difficult to treat T2N0M0 NSCLC, especially T2b (>5 cm) tumor, with SBRT. Our hypothesis was that particle therapy might be superior to SBRT in T2 patients. We evaluated the clinical outcome of particle therapy for T2a/bN0M0 NSCLC staged according to the 7th edition of the International Union Against Cancer (UICC) tumor, node, metastasis classification.
  
  
  METHODS
  : From April 2003 to December 2009, 70 histologically confirmed patients were treated with proton (n = 43) or carbon-ion (n = 27) therapy according to institutional protocols. Forty-seven patients had a T2a tumor and 23 had a T2b tumor. The total dose and fraction (fr) number were 60 (Gray equivalent) GyE/10 fr in 20 patients, 52.8 GyE/4 fr in 16, 66 GyE/10 fr in 16, 80 GyE/20 fr in 14, and other in four patients, respectively. Toxicities were scored according to the Common Terminology Criteria for Adverse Events, Version 4.0.
  
  
  RESULTS
  : The median follow-up period for living patients was 51 months (range, 24-103). For all 70 patients, the 4-year overall survival, local control, and progression-free survival rates were 58% (T2a, 53%; T2b, 67%), 75% (T2a, 70%; T2b, 84%), and 46% (T2a, 43%; T2b, 52%), respectively, with no significant differences between the two groups. The 4-year regional recurrence rate was 17%. Grade 3 pulmonary toxicity was observed in only two patients.
  
  
  CONCLUSIONS
  : Particle therapy is well tolerated and effective for T2a/bN0M0 NSCLC. To further improve treatment outcome, adjuvant chemotherapy seems a reasonable option, whenever possible.
authors: Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. h-iwa-ncu@nifty.com
authors: Hiromitsu
authors: H
authors: Iwata
authors: Yusuke
authors: Y
authors: Demizu
authors: Osamu
authors: O
authors: Fujii
authors: Kazuki
authors: K
authors: Terashima
authors: Masayuki
authors: M
authors: Mima
authors: Yasue
authors: Y
authors: Niwa
authors: Naoki
authors: N
authors: Hashimoto
authors: Takashi
authors: T
authors: Akagi
authors: Ryohei
authors: R
authors: Sasaki
authors: Yoshio
authors: Y
authors: Hishikawa
authors: Mitsuyuki
authors: M
authors: Abe
authors: Yuta
authors: Y
authors: Shibamoto
authors: Masao
authors: M
authors: Murakami
authors: Nobukazu
authors: N
authors: Fuwa
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D000368:Aged; D000369:Aged, 80 and over; D002244:Carbon / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D011379:Prognosis; D061766:Proton Therapy; D015996:Survival Rate
chemical_list: D002244:Carbon