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Gregory J. Riely, MD, PhD


Hypofractionated Proton Therapy Plus Chemotherapy for Locally Advanced Lung Cancer

By: Joshua D. Madera, MS
Posted: Thursday, June 30, 2022

For patients with locally advanced non–small cell lung cancer (NSCLC), the use of hypofractionated proton therapy in conjunction with chemotherapy may improve outcomes, according to a multicenter phase I/II nonrandomized, multicenter study, published in the International Journal of Radiation • Oncology • Biology • Physics. Additional studies with larger patient populations are warranted to further substantiate these results, commented Bradford S. Hoppe, MD, MPH, of Mayo Clinic, Jacksonville, Florida, and colleagues.

From 2013 to 2018, a total of 28 patients with NSCLC were recruited for the study. All patients had stage II (n = 6) or stage III (n = 22) unresectable NSCLC, as determined by the American Joint Committee on Cancer 7th Edition guidelines. Patients were between 50 and 86 years old. They received 2.5 to 4 Gy per fraction of hypofractionated proton therapy, to a total of 60 Gy, concurrently with platin-based doublet chemotherapy.

The study findings revealed 1-year and 3-year overall survival rates of 89% and 49%, respectively, after a median follow-up of 31 months. In addition, 1-year and 3-year progression-free survival rates were 58% and 32%, respectively. The development of grade 3 or higher radiation-related pulmonary toxicity was observed in 14% of patients. No incidents of acute grade 3 or higher esophagitis were documented. Moreover, the number of radiation treatments was reduced by approximately 3 to 4 weeks.

“This reduction in [the] number of treatments can greatly reduce the cost of care, burden of treatment on the patient, and disparities in access to proton therapy,” explained Dr. Hoppe.

Disclosure: For full disclosures of the study authors, visit

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