Carbon Ion Radiotherapy for Stage I Non-small Cell Lung Cancer Using a Regimen of Four Fractions during 1 Week

Miyamoto, Tadaaki; Baba, Masayuki; Sugane, Toshio; Nakajima, Mio; Yashiro, Tomoyasu; Kagei, K.; Hirasawa, Naoki; Sugawara, Toshiyuki; Yamamoto, Naoyoshi; Koto, Masashi; Ezawa, Hidefumi; Kadono, Kennoshuke; Tsujii, Hirohiko; Mizoe, Jun Etsu; Yoshikawa, Ken; Kandatsu, Susumu; Fujisawa, Takehiko

doi:10.1097/jto.0b013e3181560a68

Cited by 167 publications

(121 citation statements)

References 34 publications

(56 reference statements)

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“…The 2-year local control rate and OS were 93 and 89%, respectively, and the rate of radiation pneumonitis that was above grade 2 was only 4%. These results are comparable to that of a previous study of C-ion RT (8). However, additional follow-up is required to assess long-term outcomes and late adverse events following C-ion RT.…”

Section: Discussionsupporting

confidence: 80%

“…For stage I NSCLC, a number of studies of C-ion RT revealed that its efficacy and safety were comparable to SBRT (8)(9)(10). Despite the high rate of local control in C-ion RT for stage I NSCLC, regional lymph node or distant metastasis are relatively common (8,9). Identifying patients with a high risk of metastasis is important and adjuvant chemotherapy may decrease the level of metastasis in these patients.…”

Section: Introductionmentioning

confidence: 99%

“…Considering these advantages, C-ion RT is expected to achieve high local control rates without severe adverse events in several types of tumor. For stage I NSCLC, a number of studies of C-ion RT revealed that its efficacy and safety were comparable to SBRT (8)(9)(10). Despite the high rate of local control in C-ion RT for stage I NSCLC, regional lymph node or distant metastasis are relatively common (8,9).…”

Section: Introductionmentioning

confidence: 99%

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Maximum standardized uptake value on FDG-PET predicts survival in stage I non-small cell lung cancer following carbon ion radiotherapy

et al. 2017

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Abstract. The present study (University Hospital Medical Information Network study no. UMIN000003797) aimed to evaluate whether the maximum standardized uptake value (SUV max ) of pretreatment 18 F-fluorodeoxyglucose-positron emission tomography (FDG-PET) is prognostic factor for stage I non-small cell lung cancer (NSCLC) treated with carbon ion radiotherapy (C-ion RT). Patients treated between June 2010 and June 2013 at Gunma University Heavy Ion Medical Center (Maebashi, Japan) on a prospective protocol were included in the present study. Patients with T1a-b and T2a NSCLC were treated with C-ion RT at a dose of 52.8 Gy [relative biological effectiveness (RBE)] and 60.0 Gy (RBE), respectively, in four fractions. Prior to treatment, all patients underwent FDG-PET, in which the SUV max of primary tumors was evaluated. Local control, progression-free survival (PFS), and overall survival (OS) were calculated. A total of 45 patients were analyzed and the median follow-up period was 28.9 months. The 2-year local control, PFS and OS rates for all patients were 93, 78 and 89%, respectively. The mean SUV max of primary tumors was 5.5, and patients were divided into higher (≥5.5) and lower (<5.5) SUV max groups. The 2-year PFS rates were 61 and 89% for the higher and lower SUV max groups, respectively (P=0.01), and the 2-year OS rates for the higher and lower SUV max groups were 76 and 96%, respectively (P=0.01). The higher SUV max group exhibited a significantly worse PFS and OS compared with the lower SUV max group; however, the SUV max was not associated with the local control rate. In total, 2 patients (4%) experienced grade 2 or 3 radiation pneumonitis, with their symptoms improved through conservative treatment. No patients experienced any grade 4 or 5 toxicities. The results of the present study indicate that pretreatment SUV max is a prognostic indicator for outcomes in patients with stage I NSCLC treated with C-ion RT.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Maximum standardized uptake value on FDG-PET predicts survival in stage I non-small cell lung cancer following carbon ion radiotherapy

et al. 2017

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“…The carbon-ion therapy protocol, 52.8 GyE in 4 fractions, was defined according to the protocol used at the National Institute of Radiological Sciences in Chiba, Japan. 17 All radiation doses were delivered to the center of the tumor. All irradiation was given once a day, 5 days a week.…”

Section: Treatment Protocolsmentioning

confidence: 99%

High‐dose proton therapy and carbon‐ion therapy for stage I nonsmall cell lung cancer

Iwata

Murakami

Demizu

et al. 2010

Cancer

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patients with stage I NSCLC were treated with proton therapy or carbon-ion therapy (57 with proton therapy and 23 with carbon-ion therapy) using 3 treatment protocols. In the first protocol, 80 gray equivalents (GyE) of proton therapy was given in 20 fractions, and the second proton therapy protocol used 60 GyE in 10 fractions. For carbon-ion therapy, 52.8 GyE was given in 4 fractions. After achieving promising preliminary results for the first protocol, the authors started to use the second proton therapy protocol to shorten the overall treatment time. Carbon-ion therapy was started in 2005, and thereafter, both proton and carbon-ion therapy plans were made for each patient, and the 1 that appeared superior was adopted. Patient age ranged from 48 to 89 years (median, 76 years). Thirty-seven patients were medically inoperable, and 43 refused surgery. Forty-two patients had T1 tumors, and 38 had T2 tumors. RESULTS: The median follow-up period for living patients was 35.5 months. For all 80 patients, the 3-year overall survival, cause-specific survival, and local control rates were 75% (IA: 74%; IB: 76%), 86% (IA: 84%; IB: 88%), and 82% (IA: 87%; IB: 77%), respectively. There were no significant differences in treatment results among the 3 protocols. Grade 3 pulmonary toxicity was observed in only 1 patient. CONCLUSIONS: Proton therapy and carbon-ion therapy are safe and effective for stage I NSCLC. Further investigation of particle therapy for stage I NSCLC is warranted. Cancer 2010;116:2476-85.

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“…The microscopic findings in our patient implied that the relapse pattern was marginal recurrence rather than infield recurrence, 4) even though a sufficient margin around the tumor had been set for the CIRT. While our single case is not enough for a discussion of the risk factors for local recurrence after CIRT, our case suggested that we should be careful while treating GGO lesions by radiotherapy.…”

Section: Discussionmentioning

confidence: 89%

Thoracoscopic Lobectomy as Salvage Surgery for Local Recurrence of Non-Small Cell Lung Cancer after Carbon Ion Radiotherapy in an Initially Operable Patient

Sugimoto¹,

Toyooka

Suzawa³

et al. 2014

ATCS

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Carbon Ion Radiotherapy for Stage I Non-small Cell Lung Cancer Using a Regimen of Four Fractions during 1 Week

Abstract: Carbon ion beam radiotherapy with a regimen of four fractions during 1 week has been proven as a valid alternative to surgery for stage I NSCLC and to offer particular benefits, especially for elderly and inoperable patients.

Cited by 167 publications

References 34 publications

Maximum standardized uptake value on FDG-PET predicts survival in stage I non-small cell lung cancer following carbon ion radiotherapy

Maximum standardized uptake value on FDG-PET predicts survival in stage I non-small cell lung cancer following carbon ion radiotherapy

High‐dose proton therapy and carbon‐ion therapy for stage I nonsmall cell lung cancer

Thoracoscopic Lobectomy as Salvage Surgery for Local Recurrence of Non-Small Cell Lung Cancer after Carbon Ion Radiotherapy in an Initially Operable Patient

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