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- Title
Pulmonary function and toxicities of proton versus photon for limited-stage small cell lung cancer.
- Authors
Sang Hoon Seo; Hongryull Pyo; Yong Chan Ahn; Dongryul Oh; Kyungmi Yang; Nalee Kim; Jong-Mu Sun; Sehhoon Park; Hyun Ae Jung; Se-Hoon Lee; Jin Seok Ahn; Myung-Ju Ahn; Jae Myoung Noh
- Abstract
Purpose: We aimed to compare the oncological outcomes and toxicities of definitive proton beam therapy (PBT) and photon beam therapy in patients with limited-stage small cell lung cancer (LSSCLC). Materials and Methods: We retrospectively reviewed 262 patients with newly diagnosed LS-SCLC who underwent definitive PBT (n = 20; proton group) or photon beam therapy (n = 242; photon group) with concurrent chemotherapy between January 2016 and February 2021 and compared overall survival (OS), progression-free survival (PFS), dose-volume parameters, and toxicities between the groups. Results: The median follow-up duration was 24.5 months (range, 3.7 to 78.7). Baseline lung function was significantly worse and clinical target volume (CTV) was larger in the proton group (CTV: 296.6 vs. 215.3 mL; p = 0.080). The mean lung V10 was 37.7% ± 16.8% and 51.6% ± 24.5% in the proton and photon groups, respectively (p = 0.002). Two-year OS and PFS rates were 57.2% and 35.7% in the proton group and 65.3% and 40.8% in the photon group, respectively (p = 0.542 and 0.748, respectively). Grade =2 radiation pneumonitis and esophagitis occurred in 5 (25.0%) and 7 (35.0%) PBT-treated patients and 66 (27.3%) and 40 (16.5%) photon beam therapy-treated patients, respectively (p = 0.826 and 0.062, respectively). Conclusion: Although the proton group had poorer lung function and a larger CTV than that in the photon group, both groups exhibited comparable treatment outcomes and radiation-related toxicities in LS-SCLC. PBT may be a valuable therapeutic modality in patients with poor pulmonary function or extensive disease burden owing to its lung-sparing ability.
- Subjects
SMALL cell lung cancer; PROTON therapy; RADIOTHERAPY; PHOTONS; PROTONS; PHOTON beams
- Publication
Radiation Oncology Journal, 2023, Vol 41, Issue 4, p274
- ISSN
2234-1900
- Publication type
Article
- DOI
10.3857/roj.2023.00773