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Gregory J. Riely, MD, PhD
Gregory J. Riely, MD, PhD
Posted: Monday, October 21, 2024
In a 10-year follow-up study of two types of radiotherapy for locally advanced non–small cell lung cancer (NSCLC), Tingshi Su, MD, PhD, of The University of Texas MD Anderson Cancer Center, Houston, and no significant differences in local recurrence, overall survival, distant metastasis–free survival, rate of toxicity, or high-grade esophageal adverse events between passive scattering proton therapy vs intensity-modulated photon radiotherapy. These findings, which were consistent with the results of the original trial report, were presented at the 2024 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract 243).
The study included primarily patients with stage IIB to IIIB NSCLC suitable for concurrent chemoradiation therapy (at a dose of 60–74 Gy). The study included 92 patients in the photon group and 57 in the proton group; a total of 35 patients (16 given photon therapy and 19 given proton therapy) crossed over. The median follow-up for the entire group was 27.2 months. For surviving patients, the median follow-up was 69.7 months.
Grade 3 radiation pneumonitis was more prevalent with proton therapy (P = .052), whereas the group given photon therapy included two cases of grade 5 radiation pneumonitis. Grade 2 esophageal adverse events were noted 47.8% of patients who received photon therapy vs 64.9% of those who received proton therapy (P = .062). Treatment-related cardiac adverse events were noted in 30.4% vs 31.6% of those given photon vs proton therapy, respectively (P = .99).
For the group given proton therapy, overall survival rates were 36.8% at 3 years, 22.7% at 5 years, and 3.4% at 10 years. In contrast, for those given photon therapy, overall survival rates were 43.0% at 3 years, 33.1% at 5 years, and 14.6% at 10 years. Median local recurrence–free survival was 21.7 months with photon therapy and 17.2 months with proton therapy (P = .12).
Disclosure: Dr. Su reported no conflicts of interest.
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