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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

Kayoko Ohnishi  1   2 , Hitoshi Ishikawa  1   3 , Kensuke Nakazawa  4 , Toshihiro Shiozawa  4 , Yutaro Mori  1 , Masatoshi Nakamura  1 , Toshiyuki Okumura  1 , Ikuo Sekine  5 , Nobuyuki Hizawa  4 , Hideyuki Sakurai  1
Affiliations

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
See this image and copyright information in PMC

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