Carbon Ion Radiotherapy in Hypofraction Regimen for Stage I Non-Small Cell Lung Cancer

From 1994 to 1999, we conducted phase I/II clinical trial for stage I non-small cell lung cancer(NSCLC) by using carbon ion beams alone, demonstrating optimal dose of 90.0GyE in 18 fractions over 6 weeks(Protocol#9303) and 72.0GyE in 9 fractions during 3weeks (Protocol#9701) for achieving more than 95% local control with minimal pulmonary damage. In the present study, the total dose was fixed at 72.0GyE in 9 fractions over 3 weeks (Protocol#9802), and at 52.8GyE for stage IA and 60.0GyE for stage IB in four fractions during 1week (Protocol#0001).
Following this schedule, we conducted a phase II clinical trial for stage I NSCLC from 1999 to2003. We also conducted a phase I/II single fraction clinical trial (Protocol#0201) a dose escalation study. The total dose was initially 28.0GyE in 2003, and it was raised to 44.0GyE in 2007. This article describes the intermediate steps. Most target were irradiated from four oblique directions. A respiratory-gated irradiation system was used for all sessions. Local control and survival were assessed by Kaplan-Meier method. For statistical testing, the log-rank test was used.
The local control rate for all patients (#9802 and #0001) was 91.5%, and those for T1 and T2 tumors were 96.3% and 84.7%, respectively. While there was a significant difference (p=0.0156) in tumor control rate between T1 and T2, there was no significant difference (p=0.1516) between squamous cell carcinoma and non-squamous cell carcinomas. The 5-year cause-specific survival rate was 67.0%, and overall survival was 45.3%. No adverse effects greater than grade 2 occurred in the lung. In a single fraction trial, the local control rate for all 72 patients was 89.3%, and the control rates for T1 and T2 tumor were 94.6% and 78.7%, respectively. No adverse effects greater than grade 3 occurred in the lung. Carbon beam radiotherapy, an excellent new modality in terms of high QOL and ADL, was proven to be a valid alternative to surgery for stage I cancer, especially for elderly and inoperable patients.

書誌情報

NIRS-IMP Joint Symposium on Carbon Ion Therapy

巻 NIRS-M-225, p. 25-36, 発行日 2009-08

出版者

National Institute of Radiological Science

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2023-05-15 23:03:49.006861

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