Concurrent Chemo-Proton Therapy Using Adaptive Planning for Unresectable Stage 3 Non-Small Cell Lung Cancer: A Phase 2 Study
| Autor: | Hiromitsu Iwata, Misuzu Yoshihara, Toshiyuki Toshito, Eiji Kunii, Yusuke Yamaba, Kensuke Hayashi, Yuta Shibamoto, K. Nakajima, Y. Hattori, Hiroyuki Ogino, Kenji Akita, Osamu Takakuwa |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Radiation-Sensitizing Agents Cancer Research medicine.medical_specialty Lung Neoplasms Time Factors Urology Phases of clinical research Antineoplastic Agents Drug Administration Schedule 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Quality of life Carcinoma Non-Small-Cell Lung Confidence Intervals Proton Therapy medicine Clinical endpoint Humans Radiology Nuclear Medicine and imaging Prospective Studies Stage (cooking) Adverse effect Lung cancer Aged Radiation business.industry Radiotherapy Planning Computer-Assisted Incidence (epidemiology) Remission Induction Chemoradiotherapy Middle Aged medicine.disease Progression-Free Survival Confidence interval Drug Combinations Oncology 030220 oncology & carcinogenesis Quality of Life Female Cisplatin business Follow-Up Studies Radiotherapy Image-Guided |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 109:1359-1367 |
| ISSN: | 0360-3016 |
| Popis: | Purpose This study prospectively evaluated the efficacy and safety of concurrent chemo-proton therapy (CCPT) using adaptive planning for unresectable stage III non-small cell lung cancer (NSCLC). Methods and Materials The primary endpoint was overall survival (OS). Secondary endpoints were local control rate (LCR), progression-free survival (PFS), incidence of grade 3 or higher adverse events, and changes in quality of life (QOL). Patients received cisplatin (60 mg/m2) on day 1 and S-1 (∼40 mg/m2 twice daily) on days 1 to 14, q4w, for up to 4 cycles, plus concurrent proton therapy at a total dose of 70 GyRBE for the primary lesion and 66 GyRBE for lymph node metastasis with 2 GyRBE per day. Proton therapy was performed using respiratory-gated and image guided techniques, and adaptive plans were implemented. Results Forty-seven patients were enrolled between August 2013 and August 2018. Four cycles of cisplatin plus S-1 were completed in 34 patients. The mean number of cycles was 4 (range, 1-4). The median follow-up of all and surviving patients was 37 (range, 4-84) and 52 months (range, 26-84), respectively. The mean number of replanning sessions was 2.5 (range, 1-4). The 2- and 5-year OS, LCR, and PFS were 77% (95% confidence interval 64%-89%) and 59% (43%-76%), 84% (73%-95%) and 61% (44%-78%), and 43% (28%-57%) and 37% (22%-51%), respectively. The median OS was not reached. No grade 3 or higher radiation pneumonitis was observed. There was no significant deterioration in the QOL scores after 24 months except for alopecia. Conclusions CCPT with adaptive planning was well tolerated and yielded remarkable OS for unresectable stage III NSCLC. |
| Databáze: | OpenAIRE |
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