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Abstract

PURPOSE:

To evaluate the efficacy and safety of ablative dose hypofractionated proton beam therapy (PBT) for patients with stage I and recurrent non-small cell lung carcinoma (NSCLC).

PATIENTS AND METHODS:

A total of 55 patients with stage I (n = 42) and recurrent (n = 13) NSCLC underwent hypofractionated PBT and were retrospectively reviewed. A total dose of 50-72 CGE (cobalt gray equivalent) in 5-12 fractions was delivered.

RESULTS:

The median follow-up duration was 29 months (range 4-95 months). There were 24 deaths (43.6%) during the follow-up period: 11 died of disease progression and 13 from other causes. Kaplan-Meier overall survival rate (OS) at 3 years was 54.9% and the median OS was 48.6 months (range 4-95 months). Local progression was observed in 7 patients and the median time to local progression was 9.3 months (range 5-14 months). Cumulative actuarial local control rate (LCR), lymph node metastasis-free survival, and distant metastasis-free survival rates at 3 years were 85.4, 78.4, and 76.5%, respectively. Larger tumor diameter was significantly associated with poorer LCR (3-year: 94% for ≤3 cm vs. 65% for >3 cm, p = 0.006) on univariate analysis and also an independent prognostic factor for LCR (HR 6.9, 95% CI = 1.3-37.8, p = 0.026) on multivariate analysis. No grade 3 or 4 treatment-related toxicities developed. One grade 5 treatment-related adverse event occurred in a patient with symptomatic idiopathic pulmonary fibrosis.

CONCLUSIONS:

Ablative dose hypofractionated PBT was safe and promising for stage I and recurrent NSCLC.​ 

Author information​

Lee SU1, Moon SH2,3,4, Cho KH1, Pyo HR5, Kim JY1, Kim DY1, Kim TH1, Suh YG1, Kim YJ1.

1Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.

2Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea. shmoon@ncc.re.kr.

3Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea. shmoon@ncc.re.kr.

4Proton Therapy Center, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Republic of Korea. shmoon@ncc.re.kr.

5Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.