Author of

• 20169

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  P2.05 - Early Stage NSCLC (ID 706)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Early Stage NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 23348

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    P2.05-005 - Proton Beam Therapy for Early Stage Lung Cancer: A Multi-Institutional Retrospective Study in Japan (ID 9142)

    09:30 - 09:30  |  Author(s): T. Okimoto
    • Abstract

    Background:
    The purpose of this study to evaluate the clinical outcome of proton beam therapy (PBT) for early stage lung cancer or small lung lesions clinically diagnosed as primary lung cancer in Japan.
    
    Method:
    Between April 2004 and December 2013, 669 patients with 682 tumors with histologically or clinically diagnosed Stage I non-small cell lung cancer (NSCLC) according to the 7th edition of UICC were treated with PBT. The medical record and imaging studies were retrospectively reviewed to analyze survivals, local control, and toxicities.
    
    Result:
    Four hundred eighty-six (72.6%) of 669 patients were men, with the median age of 76 years (range, 42 – 94 years). Tumors were distributed according to T-stage as follows: T1a (265 tumors, 38.9%), T1b (216 tumors, 31.7%), and T2a (201 tumors, 29.4%). Tumors were distributed according to histology as follows: squamous cell carcinoma (139 tumors, 20.4%), adenocarcinoma (277 tumors, 40.6%), others (32 tumors, 4.7%), and not proven (234 tumors, 34.3%). As for operability, 351 patients were found to be operable, 294 were inoperable, and 24 patients were unknown for operability. The median biological effective dose (BED) of PBT was 109.6 Gy RBE (range, 74.4 – 131.3 Gy RBE). The median follow-up time was 38.2 months (range, 0.6 – 154.5 months) for all patients. The 3-year overall survival (OS), progression-free survival (PFS), and local control were 79.5%, 64.1%, and 89.8%, respectively. Radiation pneumonitis ≥ Grade 3 according to CTCAE v3.0 was observed in 12 (1.8%) patients. The 3-year OS and PFS for 440 patients with histologically confirmed NSCLC were 78.0% (80.7% for IA, 73.0% for IB, p = 0.042) and 66.4% (71.9% for IA, 55.9% for IB, p = 0.0038), respectively. The 3-year OS and PFS for 229 patients with clinically diagnosed NSCLC were 82.4% (86.0% for IA, 60.4% for IB, p = 0.045) and 69.6% (74.0% for IA, 42.6% for IB, p = 0.0052), respectively. The 3-year OS and PFS for 351 operable patients were 86.7% (88.8% for IA, 80.3% for IB, p = 0.096) and 70.6% (76.4% for IA, 52.8% for IB, p = 0.0028), respectively. The 3-year OS and PFS for 294 inoperable patients were 70.5% (74.1% for IA, 62.8% for IB, p = 0.046) and 56.6% (62.6% for IA, 44.6% for IB, p = 0.0062), respectively.
    
    Conclusion:
    PBT for early stage lung cancer is an effective treatment option with low incidence of severe radiation pneumonitis.