High Dose (74 GyE) Proton Beam Therapy With Concurrent Chemotherapy for Stage III Non-Small Cell Lung Cancer

2015 ◽  
Vol 93 (3) ◽  
pp. E426
Author(s):  
K. Ohnishi ◽  
T. Okumura ◽  
H. Ishikawa ◽  
Y. Oshiro ◽  
M. Mizumoto ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Proton Beam ◽  
Cell Lung Cancer ◽  
Proton Beam Therapy ◽  
Concurrent Chemotherapy ◽  
Small Cell ◽  
Stage Iii ◽  
High Dose ◽  
Small Cell Lung

scholarly journals Results of Proton Beam Therapy without Concurrent Chemotherapy for Patients with Unresectable Stage III Non-small Cell Lung Cancer

2012 ◽  
Vol 7 (2) ◽  
pp. 370-375 ◽  
Author(s):  
Yoshiko Oshiro ◽  
Masashi Mizumoto ◽  
Toshiyuki Okumura ◽  
Takayuki Hashimoto ◽  
Nobuyoshi Fukumitsu ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Proton Beam ◽  
Cell Lung Cancer ◽  
Proton Beam Therapy ◽  
Concurrent Chemotherapy ◽  
Small Cell ◽  
Stage Iii ◽  
Small Cell Lung ◽  
Unresectable Stage

Clinical Outcomes and Prognostic Factors of High-Dose Proton Beam Therapy for Peripheral Stage I Non-Small-Cell Lung Cancer

2016 ◽  
Vol 17 (5) ◽  
pp. 427-432 ◽  
Author(s):  
Yoshiomi Hatayama ◽  
Tatsuya Nakamura ◽  
Motohisa Suzuki ◽  
Yusuke Azami ◽  
Takashi Ono ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Prognostic Factors ◽  
Small Cell Lung Cancer ◽  
Clinical Outcomes ◽  
Proton Beam ◽  
Cell Lung Cancer ◽  
Proton Beam Therapy ◽  
Small Cell ◽  
High Dose ◽  
Small Cell Lung

High dose proton beam therapy (PBT) for stage I non-small cell lung cancer (NSCLC)

2005 ◽  
Vol 23 (16_suppl) ◽  
pp. 7226-7226
Author(s):  
K. Nihei ◽  
T. Ogino ◽  
S. Ishikura ◽  
H. Nishimura
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Proton Beam ◽  
Cell Lung Cancer ◽  
Proton Beam Therapy ◽  
Small Cell ◽  
Stage I ◽  
High Dose ◽  
Small Cell Lung

scholarly journals Long-Term Results of NRG Oncology RTOG 0617: Standard- Versus High-Dose Chemoradiotherapy With or Without Cetuximab for Unresectable Stage III Non–Small-Cell Lung Cancer

2020 ◽  
Vol 38 (7) ◽  
pp. 706-714 ◽  
Author(s):  
Jeffrey D. Bradley ◽  
Chen Hu ◽  
Ritsuko R. Komaki ◽  
Gregory A. Masters ◽  
George R. Blumenschein ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Radiation Dose ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Concurrent Chemotherapy ◽  
Small Cell ◽  
Stage Iii ◽  
High Dose ◽  
Small Cell Lung ◽  
Grade 3

PURPOSE RTOG 0617 compared standard-dose (SD; 60 Gy) versus high-dose (HD; 74 Gy) radiation with concurrent chemotherapy and determined the efficacy of cetuximab for stage III non–small-cell lung cancer (NSCLC). METHODS The study used a 2 × 2 factorial design with radiation dose as 1 factor and cetuximab as the other, with a primary end point of overall survival (OS). RESULTS Median follow-up was 5.1 years. There were 3 grade 5 adverse events (AEs) in the SD arm and 9 in the HD arm. Treatment-related grade ≥3 dysphagia and esophagitis occurred in 3.2% and 5.0% of patients in the SD arm v 12.1% and 17.4% in the HD arm, respectively ( P = .0005 and < .0001). There was no difference in pulmonary toxicity, with grade ≥3 AEs in 20.6% and 19.3%. Median OS was 28.7 v 20.3 months ( P = .0072) in the SD and HD arms, respectively, 5-year OS and progression-free survival (PFS) rates were 32.1% and 23% and 18.3% and 13% ( P = .055), respectively. Factors associated with improved OS on multivariable analysis were standard radiation dose, tumor location, institution accrual volume, esophagitis/dysphagia, planning target volume and heart V5. The use of cetuximab conferred no survival benefit at the expense of increased toxicity. The prior signal of benefit in patients with higher H scores was no longer apparent. The progression rate within 1 month of treatment completion in the SD arm was 4.6%. For comparison purposes, the resultant 2-year OS and PFS rates allowing for that dropout rate were 59.6% and 30.7%, respectively, in the SD arms. CONCLUSION A 60-Gy radiation dose with concurrent chemotherapy should remain the standard of care, with the OS rate being among the highest reported in the literature for stage III NSCLC. Cetuximab had no effect on OS. The 2-year OS rates in the control arm are similar to the PACIFIC trial.

scholarly journals Proton Beam Radiotherapy and Concurrent Chemotherapy for Unresectable Stage III Non–Small Cell Lung Cancer

JAMA Oncology ◽  
2017 ◽  
Vol 3 (8) ◽  
pp. e172032 ◽  
Author(s):  
Joe Y. Chang ◽  
Vivek Verma ◽  
Ming Li ◽  
Wencheng Zhang ◽  
Ritsuko Komaki ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Proton Beam ◽  
Cell Lung Cancer ◽  
Concurrent Chemotherapy ◽  
Small Cell ◽  
Stage Iii ◽  
Small Cell Lung ◽  
Proton Beam Radiotherapy ◽  
Unresectable Stage

Outcomes and Prognostic Factors for Recurrence After High-Dose Proton Beam Therapy for Centrally and Peripherally Located Stage I Non–Small-Cell Lung Cancer

2014 ◽  
Vol 15 (2) ◽  
pp. e7-e12 ◽  
Author(s):  
Ayae Kanemoto ◽  
Toshiyuki Okumura ◽  
Hitoshi Ishikawa ◽  
Masashi Mizumoto ◽  
Yoshiko Oshiro ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Prognostic Factors ◽  
Small Cell Lung Cancer ◽  
Proton Beam ◽  
Cell Lung Cancer ◽  
Proton Beam Therapy ◽  
Small Cell ◽  
Stage I ◽  
High Dose ◽  
Small Cell Lung

scholarly journals Analysis of the Association Between Low Dose Bone, Lung, and Heart Irradiation and Survival Rates for Patients Who Received High-dose Proton Beam Therapy With Concurrent Chemotherapy for Stage III Non-small Cell Lung Cancer

2021 ◽  
Author(s):  
Masatoshi Nakamura ◽  
Hitoshi Ishikawa ◽  
Kayoko Ohnishi ◽  
Yutarou Mori ◽  
Keiichiro Baba ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Proton Beam ◽  
Proton Beam Therapy ◽  
Concurrent Chemotherapy ◽  
Small Cell ◽  
Stage Iii ◽  
Univariable Analysis ◽  
Small Cell Lung ◽  
Free Survival

Abstract Background: Lymphocytes play an important role in the cancer immune system. We investigated influences of irradiated doses and volumes of the bone on lymphopenia and survivals in chemoradiotherapy for stage III non-small cell lung cancer (NSCLC).Methods: Data from 41 patients with stage III unresectable NSCLC who received definitive proton beam therapy (PBT) of 74 GyE with concurrent chemotherapy between 2007 and 2017 were retrospectively reviewed. The correlation between dosimetry parameters obtained from dose-volume histograms (DVHs) of the bone, lung, and heart and lymphopenia during PBT were analyzed. Maximum and minimum absolute lymphocyte counts (ALCmax and ALCmin) and maximum neutrophil/lymphocyte ratio (NLRmax) were used as indicators of lymphopenia. Clinical factors, dosimetry parameters, and indicators of lymphopenia were also evaluated for the correlation with overall survival (OS), progression-free survival (PFS), and distant metastasis-free survival (DMFS).Results: Significant inverse correlations were observed between bone V5 and ALCmax (ρ = -0.377, p = 0.015) and ALCmin (ρ = -0.441, p = 0.003) during the treatment period. Also, significant correlation between bone V5 and NLRmax (ρ = 0.398, p = 0.010) was observed, but bone V5 exhibited no significant association with OS, PFS, or DMFS. On the other hand, heart V5 (Hazard ratio [HR]: 1.032, p = 0.023), ALCmax (HR: 0.999, p = 0.049), and NLRmax (HR: 1.035, p = 0.007) were significantly associated with OS in univariable analysis. Lung V5 tended to be associated with PFS in univariable analysis (HR: 1.047, p = 0.056) and was significantly associated with DMFS (HR: 1.075, p =0.005). In multivariable analysis, heart V5 was not associated with OS, whereas ALCmax was significantly associated with OS (HR: 0.999, p = 0.022). Lung V5 was not a factor associated with PFS, but it was significantly associated with DMFS (HR: 1.062, p = 0.027).Conclusions: In PBT with chemotherapy for stage III NSCLC, lymphopenia was correlate with irradiation doses to the bone and lung, and lung dose but not bone dose was associated with DMFS.

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