Lung Cancer

PV QA 4 - Poster Viewing Q&A 4

TU_33_3648 - Results of Hypofractionated Carbon-Ion Radiation Therapy for Peripherally Located Stage I Non-Small-Cell Lung Cancer

Tuesday, October 23
2:45 PM - 4:15 PM
Location: Innovation Hub, Exhibit Hall 3

Results of Hypofractionated Carbon-Ion Radiation Therapy for Peripherally Located Stage I Non-Small-Cell Lung Cancer
Y. Shioyama1, K. Terashima1, H. Suefuji1, M. Shinoto1, S. Toyama1, K. Matsumoto2, A. Matsunobu1, and K. Oshima1; 1Ion Beam Therapy Center, SAGA HIMAT Foundation, Tosu, Japan, 2Department of Radiology Informatics and Network, Kyushu University, Fukuoka, Japan

Purpose/Objective(s): Carbon-ion radiotherapy (C-ion RT) has excellent dose conformity and greater biological effectiveness compared with photon radiotherapy. The efficacy of C-ion RT for non-small cell lung cancer (NSCLC) has been suggested in several previous studies. The purpose of this study was to evaluate the treatment outcomes of hypofractionated C-ion RT for peripherally located stage I NSCLC in our institution.

Materials/Methods: Clinical outcome of 101 patients (male: 59, female 42) with peripherally located stage I (IA: 74, IB: 27) NSCLC treated with C-ion RT from April 2014 to March 2017 were analyzed. The median age at the time of C-ion RT was 75 (range: 40-89) years. Histology was proven in 50 patients (adenocarcinoma 41, squamous cell carcinoma 6, others 3). Of total patients, 31 (31%) were considered medically inoperable. Seven patients also had interstitial lung disease. Prescribed dose of C-ion RT was 54.0 or 60.0 Gy (RBE) in 4 fractions for stage IA, and 60.0 or 64.0 Gy(RBE) in 4 fractions for stage IB. All patients were treated with respiratory gated irradiation. No patients received systemic chemotherapy. Common Terminology Criteria for Adverse Events version 4.0 was used to score toxicity.

Results: The median follow-up period for all patients was 23.6 months (range, 6.0–46.1 months). The overall and progression-free survival rates at two years were 93.2% (IA: 93.4%, IB: 92.3%) and 82.3% (IA: 89.5%, IB: 61.3%), respectively. The local control rate at two years was 96.4% (IA: 98.4%, IB: 90.0%). The progression-free survival and local control rates in stage IA patients was significantly better than those in stage IB patients. There was no significant difference in overall survival, progression-free survival or local control rate between histology proven and unproven patients, and also between operable and inoperable patients. The occurrence rate of grade 2 radiation pneumonitis was only 3%. No grade 3 or higher C-ion RT related toxicities were noted in any of the patients.

Conclusion: Hypofractionated C-ion RT using 4 fractions is a safe and effective treatment for patients with peripherally located stage I non-small-cell lung cancer.

Author Disclosure: Y. Shioyama: None. K. Terashima: None. H. Suefuji: None. S. Toyama: None.

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