Carbon ion radiotherapy for stage I non-small cell lung cancer using a regimen of four fractions during 1 week
Tadaaki Miyamoto, Masayuki Baba, Toshio Sugane, Mio Nakajima, Tomoyasu Yashiro, Kennji Kagei, Naoki Hirasawa, Toshiyuki Sugawara, Naoyoshi Yamamoto, Masashi Koto, Hidefumi Ezawa, Kennoshuke Kadono, Hirohiko Tsujii, Jun-etsu Mizoe, Kyosan Yoshikawa, Susumu Kandatsu, Takehiko Fujisawa, Working Group for Lung Cancer, Tadaaki Miyamoto, Masayuki Baba, Toshio Sugane, Mio Nakajima, Tomoyasu Yashiro, Kennji Kagei, Naoki Hirasawa, Toshiyuki Sugawara, Naoyoshi Yamamoto, Masashi Koto, Hidefumi Ezawa, Kennoshuke Kadono, Hirohiko Tsujii, Jun-etsu Mizoe, Kyosan Yoshikawa, Susumu Kandatsu, Takehiko Fujisawa, Working Group for Lung Cancer
Abstract
Background: A phase I/II study was first conducted for the treatment of stage I non-small cell lung cancer (NSCLC) from 1994 to 1999 to determine the optimal dose. On the basis on the results, a phase II study using a regimen of four fractions during 1 week was performed. The purpose of the present study was to determine the local control and 5-year survival rates.
Methods: From December 2000 to November 2003, 79 patients with 80 primary lesions were treated. Using a fixed dose of 52.8 GyE for stage IA NSCLC and 60.0 GyE for stage IB NSCLC in four fractions during 1 week, the primary tumors were irradiated with carbon beams alone. The average age of the patients was 74.8 years. Sixty-two (78.5%) of these patients were medically inoperable. Local control and survival were determined using the Kaplan-Meier method. The data were statistically processed using the log-rank test.
Results: All patients were observed for a minimum of 3 years or until death, with a median follow-up time of 38.6 months, ranging from 2.5 to 72.2 months. The local control rate for all patients was 90% (T1: 98%, T2: 80%). The patients' 5-year lung cancer-specific survival rate was 68% (IA: 87%, IB: 42%). The overall survival was 45% (IA: 62%, IB: 25%). Half of the deaths were attributable to intercurrent diseases. No toxic reactions in the lung greater than grade 3 were detected.
Conclusion: 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.
Source: PubMed