Ablative dose proton beam therapy for stage I and recurrent non-small cell lung carcinomas : Ablative dose PBT for NSCLC.
OBJECTIVE
To evaluate the efficacy and safety of ablative dose hypofractionated proton beam therapy (PBT) for patients with stage I and recurrent non-small cell lung carcinoma (NSCLC).


METHODS
A total of 55 patients with stage I (n = 42) and recurrent (n = 13) NSCLC underwent hypofractionated PBT and were retrospectively reviewed. A total dose of 50-72 CGE (cobalt gray equivalent) in 5-12 fractions was delivered.


RESULTS
The median follow-up duration was 29 months (range 4-95 months). There were 24 deaths (43.6%) during the follow-up period: 11 died of disease progression and 13 from other causes. Kaplan-Meier overall survival rate (OS) at 3 years was 54.9% and the median OS was 48.6 months (range 4-95 months). Local progression was observed in 7 patients and the median time to local progression was 9.3 months (range 5-14 months). Cumulative actuarial local control rate (LCR), lymph node metastasis-free survival, and distant metastasis-free survival rates at 3 years were 85.4, 78.4, and 76.5%, respectively. Larger tumor diameter was significantly associated with poorer LCR (3-year: 94% for ≤3 cm vs. 65% for >3 cm, p = 0.006) on univariate analysis and also an independent prognostic factor for LCR (HR 6.9, 95% CI = 1.3-37.8, p = 0.026) on multivariate analysis. No grade 3 or 4 treatment-related toxicities developed. One grade 5 treatment-related adverse event occurred in a patient with symptomatic idiopathic pulmonary fibrosis.


CONCLUSIONS
Ablative dose hypofractionated PBT was safe and promising for stage I and recurrent NSCLC.
Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.
Sung Uk
SU
Lee
Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea. shmoon@ncc.re.kr.|Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea. shmoon@ncc.re.kr.|Proton Therapy Center, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Republic of Korea. shmoon@ncc.re.kr.
Sung Ho
SH
Moon
Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.
Kwan Ho
KH
Cho
Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Hong Ryull
HR
Pyo
Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.
Joo Young
JY
Kim
Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.
Dae Yong
DY
Kim
Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.
Tae Hyun
TH
Kim
Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.
Yang-Gun
YG
Suh
Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.
Yeon-Joo
YJ
Kim
D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy*; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; 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; D015995:Prevalence; D061766:Proton Therapy / Q000379:methods* / Q000401:mortality; D011879:Radiotherapy Dosage; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
Non-small-cell lung carcinoma; Proton beam therapy