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. 2021 May;12(9):1320-1327.
doi: 10.1111/1759-7714.13896. Epub 2021 Mar 6.

Long-term outcomes of high-dose (74 GyE) proton beam therapy with concurrent chemotherapy for stage III nonsmall-cell lung cancer

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Long-term outcomes of high-dose (74 GyE) proton beam therapy with concurrent chemotherapy for stage III nonsmall-cell lung cancer

Kayoko Ohnishi et al. Thorac Cancer. 2021 May.

Abstract

Background: To evaluate the long-term outcomes of high-dose (74 GyE) proton beam therapy (PBT) with concurrent chemotherapy for stage III non-small cell lung cancer (NSCLC).

Methods: Between July 2007 and March 2018, 45 patients with stage III NSCLC were treated with passive-scattering PBT of 74 GyE and concurrent chemotherapy. Among the 45 patients, the median age was 62 years (range 39-79 years) and 32 patients were men. The clinical stages were stage IIIA in 14 patients and stage IIIB in 31 patients. Thirty-six patients received chemotherapy consisting of cisplatin and vinorelbine.

Results: The median follow-up time was 42.1 months (range 6.4-127.0 months) for all patients and 63.5 months (range 9.4-127.0 months) for the 12 survivors. The 3- and 5-year overall survival rates were 63.7% and 38.8%, respectively, and the median overall survival was 49.1 months. Over the follow-up period, disease recurrence was observed in 32 (71%) patients. The 3- and 5-year progression-free survival rates were 22.2% and 17.7%, respectively, with a median progression-free survival of 13.1 months. In-field control improved survival and the in-field control rate was better in patients with T0-3 tumors (p = 0.023) and stage IIIA/IIIB-N3 disease (p = 0.030). Dosimetric parameters of the heart and lung were not associated with survival. No grade 4 or 5 acute or late non-hematologic toxicities were observed.

Conclusions: Passive-scattering PBT of 74 GyE with chemotherapy showed favorable survival and a low incidence of severe adverse events in patients with stage III NSCLC.

Keywords: concurrent chemotherapy; proton beam therapy; stage III non-small cell lung cancer.

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Figures

FIGURE 1
FIGURE 1
Dosimetric parameters of the lung and heart
FIGURE 2
FIGURE 2
Overall, progression‐free, and distant metastasis‐free survival curves for all patients. Dotted, straight, and dashed lines indicate overall (OS), progression‐free (PFS), and distant metastasis‐free survival (DMFS) rates, respectively
FIGURE 3
FIGURE 3
Local control, regional control, and in‐field lymph node control curves for all patients. Straight, dashed, and dotted lines indicate local control, regional control, and in‐field lymph node control rates, respectively

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