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. 2015 Jun;115(3):367-72.
doi: 10.1016/j.radonc.2015.05.014. Epub 2015 May 28.

Long-term outcomes after proton therapy, with concurrent chemotherapy, for stage II-III inoperable non-small cell lung cancer

Quynh-Nhu Nguyen  1 , Ngoc Bui Ly  2 , Ritsuko Komaki  2 , Lawrence B Levy  2 , Daniel R Gomez  2 , Joe Y Chang  2 , Pamela K Allen  2 , Reza J Mehran  3 , Charles Lu  4 , Michael Gillin  5 , Zhongxing Liao  2 , James D Cox  2
Affiliations

Long-term outcomes after proton therapy, with concurrent chemotherapy, for stage II-III inoperable non-small cell lung cancer

Quynh-Nhu Nguyen et al. Radiother Oncol. 2015 Jun.

Abstract

Purpose: We report long-term disease control, survival, and toxicity for patients with locally advanced non-small cell lung cancer prospectively treated with concurrent proton therapy and chemotherapy on a nonrandomized case-only observational study.

Methods: All patients received passive-scatter proton therapy, planned with 4D-CT-based simulation; all received proton therapy concurrent with weekly chemotherapy. Endpoints were local and distant control, disease-free survival (DFS), and overall survival (OS).

Results: The 134 patients (21 stage II, 113 stage III; median age 69 years) had a median gross tumor volume (GTV) of 70 cm(3) (range, 5-753 cm(3)); 77 patients (57%) received 74 Gy(RBE), and 57 (42%) received 60-72 Gy(RBE) (range, 60-74.1 Gy(RBE)). At a median follow-up time of 4.7 years, median OS times were 40.4 months (stage II) and 30.4 months (stage III). Five-year DFS rates were 17.3% (stage II) and 18.0% (stage III). OS, DFS, and local and distant control rates at 5 years did not differ by disease stage. Age and GTV were related to OS and DFS. Toxicity was tolerable, with 1 grade 4 esophagitis and 16 grade 3 events (2 pneumonitis, 6 esophagitis, 8 dermatitis).

Conclusion: This report of outcomes after proton therapy for 134 patients indicated that this regimen produced excellent OS with tolerable toxicity.

Keywords: Carboplatin; Disease control; Paclitaxel; Passive scattering; Proton beam therapy; Survival.

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Figures

Figure 1
Figure 1
(A) Overall survival, (B) local+marginal (regional) failure-free survival, and (C) distant metastasis-free survival by disease stage at diagnosis. No significant differences were found according to disease stage.
Figure 1
Figure 1
(A) Overall survival, (B) local+marginal (regional) failure-free survival, and (C) distant metastasis-free survival by disease stage at diagnosis. No significant differences were found according to disease stage.
Figure 1
Figure 1
(A) Overall survival, (B) local+marginal (regional) failure-free survival, and (C) distant metastasis-free survival by disease stage at diagnosis. No significant differences were found according to disease stage.
See this image and copyright information in PMC

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