JS5-2 - Proton Therapy with Concurrent Chemotherapy for Non-Small Cell Lung Cancer: Our Experiences and Future Direction

Abstract

Background: Proton therapy with concurrent chemotherapy for the treatment of patients with locally advanced non-small cell lung cancer (NSCLC) was introduced at our hospital in December 2011. We retrospectively evaluated the treatment compliance, toxicity, and efficacy of proton therapy with concurrent chemotherapy in patients with locally advanced NSCLC.Methods: The medical records of NSCLC patients who received proton therapy with concurrent chemotherapy at the National Cancer Center Hospital East between December 2011 and December 2013 were reviewed.Results: Twenty-nine patients received proton therapy with concurrent chemotherapy. The patient characteristics were as follows: the median age was 67 years (44-77 years); 19 patients were male; 17 patients had adenocarcinoma, 10 had squamous cell carcinoma, and 2 had NSCLC-NOS; and 5 patients had stage IIA, 9 had stage IIIA, 14 had stage IIIB, and 2 had local recurrence after surgery. All but one patient received cisplatin plus vinorelbine; the remaining patient received daily carboplatin. All but one patient received the planned proton therapy dose (60 Gy [n = 14] or 66 Gy [n = 14]). Proton therapy was terminated in one patient after the delivery of 36 Gy because of the development of liver metastases. Proton therapy was suspended in 8 patients because of the development of febrile neutropenia (n = 4), esophagitis (n = 3), and a fever (n = 1). Two patients (7%) experienced grade 3 esophagitis. The grade 2 toxicities included esophagitis (n = 11), dermatitis (n = 8), and pneumonitis (n = 2). Disease progression was observed in 16 patients. In-field recurrence was observed in 3 patients, distant metastases were observed in 12 patients, and both types of recurrence were observed in 1 patient.Conclusion: Proton therapy with concurrent chemotherapy is feasible, although the possible complications, such as radiation esophagitis and dermatitis, seem to be rather severe compared with standard chemoradiotherapy using photons.