Outcomes and Prognostic Factors for Recurrence After High-Dose Proton Beam Therapy for Centrally and Peripherally Located Stage I Non-Small-Cell Lung Cancer

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• 作者：Ayae Kanemoto ; Toshiyuki Okumura ; Hitoshi Ishikawa ; Masashi Mizumoto ; Yoshiko Oshiro ; Koichi Kurishima ; Shinsuke Homma ; Takayuki Hashimoto ; Ayako Ohkawa ; Haruko Numajiri ; Toshiki Ohno ; Takashi Moritake ; Koji Tsuboi ; Takeji Sakae ; Hideyuki Sakurai
• 关键词：Outcome ; Prognostic factor for tumor control ; Proton beam therapy ; Stage I lung cancer ; Radiation dose
• 刊名：Clinical Lung Cancer
• 出版年：March, 2014
• 年：2014
• 卷：15
• 期：2
• 页码：e7-e12
• 全文大小：378 K

文摘

Introduction

This study was conducted to determine disease control rates and prognostic factors associated with recurrence of centrally and peripherally located stage I NSCLC treated using high-dose PBT.

Patients and Methods

Seventy-four patients with 80 centrally or peripherally located stage I NSCLCs were treated with PBT. A protocol using 72.6 Gy (RBE) in 22 fractions was used for centrally located tumors, and 66 Gy (RBE) in 10 or 12 fractions was used for peripherally located tumors. Data were collected and control rates and prognostic factors for recurrence were evaluated retrospectively.

Results

The median follow-up period was 31.0 months. The overall survival, disease-specific survival, and progression-free survival rates were 76.7%, 83.0%, and 58.6% at 3 years, respectively. Disease recurrence was noted in 30 patients and local recurrence of 11 tumors occurred. The 3-year local control rate was 86.2% for stage IA tumors and 67.0% for stage IB tumors. Radiation dose was identified as a significant prognostic factor for disease recurrence and local recurrence. Tumor diameter and age were only significantly associated with disease recurrence. The 3-year local control rate was 63.9% for centrally located tumors irradiated with 72.6 Gy (RBE) and 88.4% for peripherally located tumors irradiated with 66 Gy (RBE).

Conclusion

Radiation dose was shown to be the most significant prognostic factor for tumor control in stage I NSCLC treated using high-dose PBT. Tumor diameter was not significant for local control. Further evaluation of PBT for centrally located tumors is warranted.