Abstract
IntroductionTo investigate the treatment outcomes of passive scattering proton beam therapy using stereotactic ablative radiotherapy (SABR) or hypofractionated radiation therapy (RT) for inoperable patients or those who refused surgery for stage I non-small cell lung cancer (NSCLC).MethodsFrom January 2016 to December 2019, we retrospectively analyzed 42 patients with stage I NSCLC treated with proton beam therapy. The initially intended dose regimen was 60 cobalt Gray equivalents (CGE) in 4 fractions; however, sequentially modified dose regimens were used when the dose-volume constraints could not be met. The median total dose was 50 CGE (range 50–70 CGE), while the corresponding median biologically effective dose using alpha{/}beta= 10 (BED10) was 112.5 CGE (range 96–150 CGE).ResultsThe median follow-up time was 40 months (interquartile range 32–48 months). Among the 42 treated patients, 33 had pathologically proven cancers of which most were adenocarcinoma (n = 21, 64%). The 3-year overall survival rate was 71.8%. The estimated rates of local control and progression free survival at 3 years were 91.5% and 66.9%, respectively. Thirteen patients experienced disease progression consisting of three local, six regional, and nine distant failures. No grade 4 or 5 toxicities were observed.ConclusionPassive scattering proton beam therapy for stage I NSCLC using SABR or hypofractionated RT was safe and showed high LC rates.
Highlights
To investigate the treatment outcomes of passive scattering proton beam therapy using stereotactic ablative radiotherapy (SABR) or hypofractionated radiation therapy (RT) for inoperable patients or those who refused surgery for stage I non-small cell lung cancer (NSCLC)
This study evaluated the treatment outcomes of passive scattering proton beam therapy (PBT) using SABR and hypofractionated RT in patients with stage I NSCLC
In the current study, we reported the treatment outcomes of passive scattering PBT for stage I NSCLC in 42 patients
Summary
To investigate the treatment outcomes of passive scattering proton beam therapy using stereotactic ablative radiotherapy (SABR) or hypofractionated radiation therapy (RT) for inoperable patients or those who refused surgery for stage I non-small cell lung cancer (NSCLC). Multiple radiation fields or arcs are used to accurately deliver high doses during photon-based SABR which increases the low-dose bath volume in critical thoracic organs. This may result in some toxicities, especially in patients with compromised lung function, severe underlying lung conditions, or older patients with comorbidities. By creating a spread-out Bragg peak (SOBP) by the energy deposition region of each beam, the entire target volume can be covered with a uniform dose This characteristic of proton beam therapy (PBT) allows organs at risk (OARs) to be spared while delivering higher doses with high accuracy to the target.
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