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High dose hypofractionated proton beam therapy is a safe and feasible treatment for central lung cancer Cover

High dose hypofractionated proton beam therapy is a safe and feasible treatment for central lung cancer

Radiology and Oncology
Volume 51 (2017): Issue 3 (September 2017)
By: Takashi Ono,  Tomonori Yabuuchi,  Tatsuya Nakamura,  Kanako Kimura,  Yusuke Azami,  Katsumi Hirose,  Motohisa Suzuki,  Hitoshi Wada,  Yasuhiro Kikuchi and  Kenji Nemoto  
Open Access
|Jun 2017

Figures & Tables

Figure 1

Dose distribution map of proton beam therapy for central lung cancer. The red line represents the gross tumor volume and the purple line around the tumor represents the 90% dose line. The region outside the outermost blue line is allocated to < 10% radiation.
Dose distribution map of proton beam therapy for central lung cancer. The red line represents the gross tumor volume and the purple line around the tumor represents the 90% dose line. The region outside the outermost blue line is allocated to < 10% radiation.

Figure 2

(A) The overall survival rate of the patients treated for central lung cancer. The 1- and 2-year overall survival rates were 95.0% and 73.8%, respectively. (B) The 2-year overall survival rates of operable and inoperable patients were 100% and 62.5%, respectively.
(A) The overall survival rate of the patients treated for central lung cancer. The 1- and 2-year overall survival rates were 95.0% and 73.8%, respectively. (B) The 2-year overall survival rates of operable and inoperable patients were 100% and 62.5%, respectively.

Figure 3

(A) The local control rate for patients with central lung cancer after proton beam therapy. The 2-year local control rate was 78.5%. (B) The 2-year local control rates of lung cancers with a diameter ≤ 39.5 mm and > 39.5 mm were 90% and 68.6%, respectively (p = 0.348).
(A) The local control rate for patients with central lung cancer after proton beam therapy. The 2-year local control rate was 78.5%. (B) The 2-year local control rates of lung cancers with a diameter ≤ 39.5 mm and > 39.5 mm were 90% and 68.6%, respectively (p = 0.348).

Overall survival of central lung cancer

Number of patientsMedian follow up timetreatmentOverall survival rateAll grade 3-5 toxicities
Song et al. (20)926.5 monthsSBRT50% (2-year)33%
Modh et al. (21)12517.4 monthsSBRT64% (2-year)8%
Chaudhuri et al. (22)3418.4 monthsSBRT63.2% (2-year)3%
Tekatli et al. (23)8047 monthsSBRT53% (3-year)6.4%
Bush et al. (8)3348 monthsPBTNot applicable0
present study2027.5 monthsPBT73.8% (2-year)0

Toxicities

ToxicitiesGrade 0Grade 1Grade 2Grade 3 - 5
Lung018 (90%)2 (1 0%)0
Esophagus20 (100%)000
Heart16 (80%)4 (20%)00
Bone15 (75%)3 (15%)2 (10%)0

The patient characteristics (n = 20)

CharacteristicsPatients
Age (years)
Median (range)75 (63–90)
Gender
   Male17 (85%)
   Female3 (15%)
Performance status
   08 (40%)
   18 (40%)
   24 (20%)
Charlson Index
   05 (25%)
   16 (30%)
   27 (35%)
   32 (10%)
Follow-up time (months)
Median (range)27.5 (12-72)
Chronic obstructive pulmonary disease
   Yes9 (45%)
   No11 (55%)
T category

Numbers correspond to the tumor-node-metastasis system of classification (International Union Against Cancer criteria)
   T14 (20%)
   T211 (55%)
   T34 (20%)
   T41 (5%)
Stage

Numbers correspond to the tumor-node-metastasis system of classification (International Union Against Cancer criteria)
   I15 (75%)
   II4 (20%)
   III1 (5%)
Tumor location
   Right upper lobe7 (35%)
   Right middle lobe2 (10%)
   Right lower lobe6 (30%)
   Left upper lobe3 (15%)
   Left lower lobe2 (10%)
Histopathology
   Squamous cell carcinoma8 (40%)
   Adenocarcinoma5 (25%)
   Clinical malignancy7 (35%)
Diameter of lung tumor (mm)
   Median (range)39.5 (24-81)
DOI: https://doi.org/10.1515/raon-2017-0023 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
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Language: English
Page range: 324 - 330
Submitted on: Jan 17, 2017
Accepted on: May 14, 2017
Published on: Jun 16, 2017
Published by: Association of Radiology and Oncology
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
central,
lung cancer,
hypofractionated,
proton beam therapy
Related subjects:
Medicine,
Clinical medicine,
Internal medicine,
Haematology, oncology,
Radiology

© 2017 Takashi Ono, Tomonori Yabuuchi, Tatsuya Nakamura, Kanako Kimura, Yusuke Azami, Katsumi Hirose, Motohisa Suzuki, Hitoshi Wada, Yasuhiro Kikuchi, Kenji Nemoto, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution 4.0 License.

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