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Is Proton Beam Therapy Effective in Locally Controlling Early-Stage NSCLC?

By: Hope Craig, MSPH
Posted: Thursday, November 18, 2021

Researchers in Korea conducted a retrospective cohort study to investigate treatment outcomes with passive scattering proton beam therapy for patients with stage I non–small cell lung cancer (NSCLC). The study, which was reported in the journal Radiation Oncology by Yang-Gun Suh, PhD, and colleagues at the National Cancer Center of Korea, evaluated stereotactic ablative radiotherapy or hypofractionated radiation therapy for inoperable patients or those who refused surgery. Passive scattering proton beam therapy was found to be safe and yielded high local control rates in this patient population via stereotactic ablative radiotherapy or hypofractionated radiation.

A total of 42 patients with stage I NSCLC treated with proton beam therapy were included. More than half of patients were male (n = 27, 64%), and the median age was 78. Most patients (n = 39, 93%) were determined to be inoperable; three patients (7%) had refused surgery. The median total dose was 50 cobalt Gray equivalents (CGE).

Patients were followed for a median of 40 months. Most patients (n = 33, 79%) had pathologically proven cancers, most of which were adenocarcinoma (n = 21, 64%). The 3-year overall survival rate was 72 %, at which point estimated rates of local control and progression-free survival were 91.5% and 70%, respectively.

“Proton beam therapy showed an excellent local control with minimal radiation exposure to organs at risk, including, the lung, the heart, hilar vessels, and proximal bronchial tree,” reported the investigators. “Consequently, a highly favorable toxicity profile has been observed, while most patients are medically inoperable due to underlying diseases. Moreover, patients with poor pulmonary function and/or tumors located close to the heart may be more beneficial when treated with proton beam therapy,” the authors continued.

Disclosure: The authors reported no conflicts of interest.



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