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Multicenter Study
. 2024 Sep:198:110385.
doi: 10.1016/j.radonc.2024.110385. Epub 2024 Jun 18.

Proton and carbon ion radiotherapy for operable early-stage lung cancer; a prospective nationwide registry

Hideyuki Harada  1 , Hiroaki Suefuji  2 , Keita Mori  3 , Hitoshi Ishikawa  4 , Masaki Nakamura  5 , Sunao Tokumaru  6 , Masao Murakami  7 , Takashi Ogino  8 , Hiromitsu Iwata  9 , Hitoshi Tatebe  10 , Nobuteru Kubo  11 , Takahiro Waki  12 , Daisaku Yoshida  13 , Masatoshi Nakamura  14 , Takayuki Hashimoto  15 , Masayuki Araya  16 , Mio Nakajima  17 , Haruhiko Nakayama  18 , Miyako Satouchi  19 , Yoshiyuki Shioyama  20
Affiliations
Multicenter Study

Proton and carbon ion radiotherapy for operable early-stage lung cancer; a prospective nationwide registry

Hideyuki Harada et al. Radiother Oncol. 2024 Sep.

Abstract

Background and purpose: To investigate the toxicity and survival outcomes of proton and carbon ion radiotherapy for patients with operable early-stage lung cancer who are eligible for lobectomy.

Materials and methods: This multicenter nationwide prospective cohort study included patients with operable early-stage lung cancer. Proton and carbon ion radiotherapy was performed according to the schedule stipulated in the unified treatment policy. Progression-free survival (PFS), overall survival (OS) and treatment-related toxicities were evaluated.

Results: A total of 274 patients were enrolled and included in efficacy and safety analyses. The most common tumor type was adenocarcinoma (44 %), while 105 cases (38 %) were not histologically confirmed or diagnosed clinically. Overall, 250 (91 %) of the 274 patients had tumors that were peripherally situated, while 138 (50 %) and 136 (50 %) patients were treated by proton and carbon ion radiotherapy, respectively. The median follow-up time for all censored patients was 42.8 months (IQR 36.7-49.0). Grade 3 or severe treatment-related toxicity was observed in 4 cases (1.5 %). Three-year PFS was 80.5 % (95 % CI: 75.7 %-85.5 %) and OS was 92.5 % (95 % CI: 89.3 %-95.8 %). Pathological confirmation and clinical stage were factors significantly associated with PFS, while tumor location and particle-ion type were not. Meanwhile, clinical stage was significantly associated with OS, but pathological confirmation, tumor location, and particle-ion type were not.

Conclusions: Particle therapy for operable early-stage lung cancer resulted in excellent 3-year OS and PFS in each subset. In this disease context, proton and carbon ion beam therapies are feasible alternatives to curative surgery.

Keywords: Carbon; Lung cancer; National registry; Operable; Particle therapy; Proton; Radiotherapy.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that would directly affect the research reported in this paper. Hideyuki Harada received Honoraria from Astrazeneca, Accuray, Chugai pharmaceutical, Takeda pharmaceutical, MSD, Eizai pharmaceutical, Phizer, Brainlab, Hitachi, Novartis, Guerbet Japan, GE Healthcare, Nihon Medi-Physics and Taiho pharmaceutical outside this work. Keita Mori received Honoraria from Chugai Pharmaceutical, Ono Pharmaceutical, Bristol Myers Squibb, Daiichi-Sankyo and Eli Lilly Japan outside this work. Hitoshi Ishikawa received Honoraria from Boston Scientific Corporation and MSD outside this work. Masaki Nakamura received Honoraria from Astrazeneca outside this work. Nobuteru Kubo received Honoraria from Astrazeneca outside this work. Miyako Satouchi received Honoraria from Chugai pharmaceutical, Astrazeneca,Eli Lilly Japan, Ono pharmaceutical, Bristol-Myers Squibb, MSD, Merck Janssen Pharmaceutical, Amgen, Taiho pharmaceutical, Pfizer, Daiichi-Sankyo, Eisai, Takeda pharmaceutical, Novartis, GlaxoSmithKline Consumer Healthcare Japan and Bayer pharmaceutical and research funding from GlaxoSmithKline, AstraZeneca, MSD, Janssen, Amgen, Taiho pharmaceutical, Ono pharmaceutical, Bristol Myers Squibb, Pfizer, Daiichi-Sankyo, and Eisai outside this work. Yoshiyuki Shioyama received Honoraria from Astrazeneca outside this work.

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