Ablative dose proton beam therapy for stage I and recurrent non-small cell lung carcinomas

Lee, Sung Uk; Moon, Sung Ho; Cho, Kwan Ho; Pyo, Hong Ryull; Kim, Joo Young; Kim, Dae Yong; Kim, Tae Hyun; Suh, Yong Jae; Kim, Yeon-Joo

doi:10.1007/s00066-016-0985-9

Cited by 9 publications

(16 citation statements)

References 42 publications

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“…published proton SBRT studies [9,16]. In our study, the cause-specific survival rates at 3 and 5 years were 100% and 75%, respectively, which is considerably higher than overall survival, underscoring the role of competing comorbidities in this medically frail population of patients.…”

Section: Discussionmentioning

confidence: 48%

“…We recognize, however, that the treatment planning techniques and treatment volume specifications varied between the 2 studies. Investigators from Loma Linda University and the National Cancer Center of Korea analyzing hypofractionated proton therapy for early-stage NSCLC have reported no grade 3 through 4 treatment toxicities [16], acute pneumonitis, or late esophageal and cardiac toxicities [9]. A meta-analysis that compared photon-based radiation to particlebased radiation for early-stage NSCLC also found lower rates of grade 3 through 4 pneumonitis and grade 3 through 4 irreversible dyspnea in patients who received proton therapy [23].…”

Section: Discussionmentioning

confidence: 99%

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Image-Guided Hypofractionated Proton Therapy in Early-Stage Non–Small Cell Lung Cancer: A Phase 2 Study

Kharod

Nichols

Henderson

et al. 2020

International Journal of Particle Therapy

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Purpose Due to the excellent outcomes with image-guided stereotactic body radiotherapy for patients with early-stage non–small cell lung cancer (NSCLC) and the low treatment-related toxicities using proton therapy (PT), we investigated treatment outcomes and toxicities when delivering hypofractionated PT. Materials and Methods Between 2009 and 2018, 22 patients with T1 to T2 N0M0 NSCLC (45% T1, 55% T2) received image-guided hypofractionated PT. The median age at diagnosis was 72 years (range, 58-90). Patients underwent 4-dimensional computed tomography simulation following fiducial marker placement, and daily image guidance was performed. Nine patients (41%) were treated with 48 GyRBE in 4 fractions for peripheral lesions, and 13 patients (59%) were treated with 60 GyRBE in 10 fractions for central lesions. Patients were assessed for CTCAEv4 toxicities with computed tomography imaging for tumor assessment. The primary endpoint was grade 3 to 5 toxicity at 1 year. Results The median follow-up for all patients was 3.5 years (range, 0.2-8.8 years). The overall survival rates at 3 and 5 years were 81% and 49%, respectively. Cause-specific survival rates at 3 and 5 years were 100% and 75%, respectively. The 3-year local, regional, and distant control rates were 86%, 85%, and 95%, respectively. Four patients experienced in-field recurrences between 18 and 45 months after treatment. One patient (5%) developed a late grade 3 bronchial stricture requiring hospitalization and stent. Conclusion Image-guided hypofractionated PT for early-stage NSCLC provides promising local control and long-term survival with a low likelihood of toxicity. Regional nodal and distant relapses remain a problem.

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Section: Discussionmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 99%

Image-Guided Hypofractionated Proton Therapy in Early-Stage Non–Small Cell Lung Cancer: A Phase 2 Study

Kharod

Nichols

Henderson

et al. 2020

International Journal of Particle Therapy

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“…The total numbers of patients who received PBT in Korea are shown by year with brief summaries of historical events since 2007 in Fig. 1 for PBT from childhood cancer alone to some adulthood cancers (central nervous system, head and neck, thoracic and abdominal malignancies except breast and prostate cancer) (S1 Table ), as favorable clinical evidence for PBT accumulated, both domestically and overseas [11][12][13][14][15][16].…”

Section: Resultsmentioning

confidence: 99%

Patterns of Proton Beam Therapy Use in Clinical Practice between 2007 and 2019 in Korea

et al. 2021

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Proton beam therapy (PBT) is a state-of-the-art technology employed in radiotherapy (RT) for cancer patients. This study characterized how PBT has been used in clinical practice in Korea. Materials and MethodsPatients who received any type of RT between 2007 and 2019 were identified from the radiation oncology registry of the two PBT facilities operating in Korea (National Cancer Center and Samsung Medical Center). The χ 2 test was used to identify patient-and treatment-related characteristics associated with the receipt of PBT. ResultsA total of 54,035 patients had been treated with some form of RT in the two institutions, of whom 5,398 received PBT (10.0%). The number of patients who receive PBT has gradually

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“…On the basis of these considerations, a reirradiation dose of 60-66 Gy can be prescribed if sufficient sparing of organs at risk can be achieved. The latter objective might be facilitated by adaptive replanning, breath-hold image-guided techniques, and proton beams, which are under investigation in numerous prospective clinical trials [49]. Finally, there was a prior RTOG/NRG proposal to consider adjuvant chemotherapy following SABR for high-risk stage I NSCLC patients, which was based on analogy with the modest benefit seen in patients receiving such chemotherapy following resection of T1b NSCLC.…”

Section: Discussionmentioning

confidence: 99%

Reirradiation of recurrent node-positive non-small cell lung cancer after previous stereotactic radiotherapy for stage I disease

et al. 2017

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The institutional recommendations reflect the questions and uncertainties discussed in current stage III guidelines. All institutions agreed that previous SABR is not a contraindication for salvage chemoradiation. In the absence of high-quality prospective trials for recurrent NSCLC, all treatment options recommended in current guidelines for stage III disease can be considered in clinical scenarios such as this.

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Ablative dose proton beam therapy for stage I and recurrent non-small cell lung carcinomas

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

Cited by 9 publications

References 42 publications

Image-Guided Hypofractionated Proton Therapy in Early-Stage Non–Small Cell Lung Cancer: A Phase 2 Study

Image-Guided Hypofractionated Proton Therapy in Early-Stage Non–Small Cell Lung Cancer: A Phase 2 Study

Patterns of Proton Beam Therapy Use in Clinical Practice between 2007 and 2019 in Korea

Reirradiation of recurrent node-positive non-small cell lung cancer after previous stereotactic radiotherapy for stage I disease

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