Ablative dose proton beam therapy for stage I and recurrent non-small cell lung carcinomas

• DOI: 10.1007/s00066-016-0985-9
• Publication Date: 2016-06-09T20:30:49Z
• Authors: Sung Uk Lee; Sung Ho Moon; Kwan Ho Cho; Hong Ryull Pyo; Joo Young Kim; Dae Yong Kim; Tae Hyun Kim; Yang-Gun Suh; Yeon-Joo Kim
• Keywords: Aged, 80 and over; Male; Lung Neoplasms; Radiotherapy Dosage; Middle Aged; Disease-Free Survival; 3. Good health; Survival Rate; 03 medical and health sciences; 0302 clinical medicine; Risk Factors; Carcinoma, Non-Small-Cell Lung; Republic of Korea; Prevalence; Proton Therapy; Humans; Female; Dose Fractionation, Radiation; Longitudinal Studies; Neoplasm Recurrence, Local; Aged; Follow-Up Studies; Neoplasm Staging

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).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.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.Ablative dose hypofractionated PBT was safe and promising for stage I and recurrent NSCLC.