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Clinical Trial
. 2014 Sep;55(5):959-65.
doi: 10.1093/jrr/rru034. Epub 2014 May 25.

High-dose concurrent chemo-proton therapy for Stage III NSCLC: preliminary results of a Phase II study

Yoshiko Oshiro  1 , Toshiyuki Okumura  1 , Koichi Kurishima  2 , Shinsuke Homma  2 , Masashi Mizumoto  1 , Hitoshi Ishikawa  1 , Masataka Onizuka  3 , Mitsuaki Sakai  3 , Yukinobu Goto  3 , Nobuyuki Hizawa  2 , Yukio Sato  3 , Hideyuki Sakurai  4
Affiliations
Clinical Trial

High-dose concurrent chemo-proton therapy for Stage III NSCLC: preliminary results of a Phase II study

Yoshiko Oshiro et al. J Radiat Res. 2014 Sep.

Abstract

The aim of this report is to present the preliminary results of a Phase II study of high-dose (74 Gy RBE) proton beam therapy (PBT) with concurrent chemotherapy for unresectable locally advanced non-small-cell lung cancer (NSCLC). Patients were treated with PBT and chemotherapy with monthly cisplatin (on Day 1) and vinorelbine (on Days 1 and 8). The treatment doses were 74 Gy RBE for the primary site and 66 Gy RBE for the lymph nodes without elective lymph nodes. Adapted planning was made during the treatment. A total of 15 patients with Stage III NSCLC (IIIA: 4, IIIB: 11) were evaluated in this study. The median follow-up period was 21.7 months. None of the patients experienced Grade 4 or 5 non-hematologic toxicities. Acute pneumonitis was observed in three patients (Grade 1 in one, and Grade 3 in two), but Grade 3 pneumonitis was considered to be non-proton-related. Grade 3 acute esophagitis and dermatitis were observed in one and two patients, respectively. Severe ( ≥ Grade 3) leukocytopenia, neutropenia and thrombocytopenia were observed in 10 patients, seven patients and one patient, respectively. Late radiation Grades 2 and 3 pneumonitis was observed in one patient each. Six patients (40%) experienced local recurrence at the primary site and were treated with 74 Gy RBE. Disease progression was observed in 11 patients. The mean survival time was 26.7 months. We concluded that high-dose PBT with concurrent chemotherapy is safe to use in the treatment of unresectable Stage III NSCLC.

Keywords: Phase II study; chemo–proton therapy; lung cancer; proton therapy; radiotherapy.

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Figures

Fig. 1.
Fig. 1.
Overall survival of patients.
Fig. 2.
Fig. 2.
Progression-free survival of patients.
See this image and copyright information in PMC

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