Ablativ dosierte Protonentherapie bei Stadium-I- und rekurrierenden nichtkleinzelligen Lungenkarzinomen : Ablativ dosierte Protonentherapie für NSCLC.

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

<bold>Purpose: </bold>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).<bold>Patients and Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusions: </bold>Ablative dose hypofractionated PBT was safe and promising for stage I and recurrent NSCLC.

SOUTH Korea; CANCER relapse; CLINICAL trials; COMPARATIVE studies; LONGITUDINAL method; LUNG cancer; LUNG tumors; RESEARCH methodology; MEDICAL cooperation; PROGNOSIS; RADIATION doses; RESEARCH; SURVIVAL; TUMOR classification; EVALUATION research; TREATMENT effectiveness; DISEASE prevalence; PROTON therapy

Strahlentherapie und Onkologie, 2016, Vol 192, Issue 9, p649

0179-7158

Academic Journal

10.1007/s00066-016-0985-9