Curative treatment of Stage I non–small-cell lung cancer with carbon ion beams using a hypofractionated regimen

Miyamoto, Tadaaki; Baba, Masayuki; Yamamoto, Naoyoshi; Koto, Masashi; Sugawara, Toshiyuki; Yashiro, Tomoyasu; Kadono, Kennoshuke; Ezawa, Hidefumi; Tsujii, Hirohiko; Mizoe, Jun Etsu; Yoshikawa, Ken; Kandatsu, Susumu; Fujisawa, Takehiko

doi:10.1016/j.ijrobp.2006.10.006

Cited by 138 publications

(95 citation statements)

References 26 publications

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“…Results on carbon-ion therapy have only been reported from the National Institute of Radiological Sciences in Chiba, Japan. 19,32 The group has been investigating various fractionation schedules (from 18 to only 1 fraction, recently). We adopted their 4-fraction protocol, and have observed favorable outcome.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

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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“…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%

“…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%

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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“…The superior biophysical and biological profiles of particle beams such as carbon beam and protons with excellent dose localization and sparing of normal tissues makes them highly attractive for treating malignant tumors including lung cancer, whereas more research is currently warranted to better evaluate the cost-effectiveness of particle therapy (5)(6)(7)(8). The phase I and II clinical trials on carbon ion radiotherapy for stage I non-small cell lung cancer (NSCLC) have showed promising results regarding local control and overall survival (5,6).…”

Section: Introductionmentioning

confidence: 99%

“…The phase I and II clinical trials on carbon ion radiotherapy for stage I non-small cell lung cancer (NSCLC) have showed promising results regarding local control and overall survival (5,6). A recent meta-analysis, though, concluded that survival rates for particle therapy were higher than those for conventional radiotherapy, but similar to sterotactic body radiotherapy in stage I inoperable NSCLC, suggesting that particle therapy may be more beneficial in stage III NSCLC, especially in reducing adverse events (8).…”

Section: Introductionmentioning

confidence: 99%

Genetic alterations after carbon ion irradiation in human lung adenocarcinoma cells

Fokas

You²,

Juricko³

et al. 2010

Int J Oncol

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Abstract. The aim of this study was to investigate the difference in gene expression profiles of human lung adenocarcinoma cells and identify genes whose expression is altered by heavy ions but not X-rays. The lung adenocarcinoma cell line A549 was irradiated with carbon ion beams and X-rays using biologically equivalent doses (2 Gy and 6 Gy, respectively). The transcriptional profiling was determined with a high density cDNA microarray containing 11.800 genes, and genetic network and gene ontology analysis was performed. The changes in selected genes involved were validated by quantitative real-time polymerase chain reaction (qRT-PCR). The microarray analysis identified 49 mapped, network-eligible genes, the expression level of which was altered by carbon ions but not by X-rays. From these, 29 were upregulated while 20 genes were downregulated 4 h postirradiation with carbon ions in A549 cells, as compared to the control. Among these, three genes (CCND2, RARG and E2F5) were involved in the aryl hydrocarbon receptor signalling and G1/S cell cycle checkpoint pathways. The microarray data were corroborated by qRT-PCR analysis of the selected genes (p<0.05). Our findings provide information on the genetic signature of carbon ions in human lung adenocarcinoma cells and add to the understanding of the complicated molecular response to carbon ion irradiation.

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Curative treatment of Stage I non–small-cell lung cancer with carbon ion beams using a hypofractionated regimen

Cited by 138 publications

References 26 publications

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

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

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

Genetic alterations after carbon ion irradiation in human lung adenocarcinoma cells

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