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Concurrent Chemotherapy and Proton Therapy in Advanced Lung Cancer

Posted: Monday, August 7, 2017

For patients with unresectable stage III non–small cell lung cancer (NSCLC), concurrent chemotherapy and high-dose (74 Gy) proton beam radiation therapy may improve outcomes, according to the final results of a phase II study published in JAMA Oncology. Joe Y. Chang, MD, PhD, of The University of Texas MD Anderson Cancer Center, and colleagues reported an overall survival of 26.5 months, compared with the historical rate of 16 months with standard-of-care concurrent chemotherapy and traditional radiation therapy.

This open-label, single-institution study, which opened in 2006, included 64 patients with advanced inoperable lung cancer. Although the median follow-up was 27.3 months for all patients, it was 79.6 months for alive patients—reportedly the longest follow-up to date of patients with stage III lung cancer who have received proton therapy.

At 5 years, the median overall survival was 26.5 months, with a corresponding 5-year overall survival of 29%. A total of 39 patients experienced a relapse, with 62% of all recurrences occurring in distant sites.

Grade 2 and 3 acute esophagitis was observed in 28% and 8% of patients, respectively. No acute or late grade 5 toxicities were reported, although they have been seen in patients who received the standard of care, noted the investigators.