QST Hospital, National Institutes for Quantum and Radiological Sciences and Technology, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan.
Department of Radiation Oncology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan.
Jpn J Radiol. 2021 Jul;39(7):703-709. doi: 10.1007/s11604-021-01101-z. Epub 2021 Feb 19.
The clinical significance of carbon-ion radiotherapy (CIRT) for octogenarians with locally advanced non-small-cell lung cancer (LA-NSCLC) remains unclear. We aimed to evaluate the clinical outcomes of CIRT alone for octogenarians with LA-NSCLC.
We evaluated 32 patients who underwent CIRT alone between 1997 and 2015. The median age was 82.0 years (range, 80-88 years). In terms of clinical stage (UICC 7th edition), 7 (21.9%), 10 (31.3%), 11 (34.4%), and 4 (12.5%) patients had stage IIA, IIB, IIIA, and ΙΙΙB disease, respectively. The median CIRT dose was 72.0 Gy (relative biological effectiveness), and the median follow-up period was 33.1 months.
All patients successfully completed CIRT. Regarding grade ≥ 2 toxicities, 1 (3.1%), 3 (9.4%), and 4 (0.7%) patients developed grade 3 radiation pneumonitis, grade 2 radiation pneumonitis, and grade 2 dermatitis, respectively. No grade ≥ 4 toxicities were observed. The 2 year LC, PFS, and OS rates were 83.5%, 46.7%, and 68.0%, respectively.
CIRT alone is safe and effective for octogenarians with LA-NSCLC.
碳离子放疗（CIRT）在 80 岁以上局部晚期非小细胞肺癌（LA-NSCLC）患者中的临床意义尚不清楚。本研究旨在评估单纯 CIRT 治疗 80 岁以上 LA-NSCLC 患者的临床疗效。
我们回顾性分析了 1997 年至 2015 年间接受单纯 CIRT 治疗的 32 例 80 岁以上的 LA-NSCLC 患者。中位年龄为 82.0 岁（范围：80-88 岁）。根据国际抗癌联盟（UICC）第 7 版分期，7 例（21.9%）、10 例（31.3%）、11 例（34.4%）和 4 例（12.5%）患者分别为ⅡA、ⅡB、ⅢA 和ⅢB 期。CIRT 中位剂量为 72.0Gy（相对生物效应），中位随访时间为 33.1 个月。
所有患者均顺利完成 CIRT 治疗。3 级及以上毒性反应发生率为 3.1%（1 例）、9.4%（3 例）和 0.7%（1 例），分别为 3 级放射性肺炎、2 级放射性肺炎和 2 级皮肤炎，未观察到 4 级及以上毒性反应。2 年局部控制率、无进展生存率和总生存率分别为 83.5%、46.7%和 68.0%。
对于 80 岁以上的 LA-NSCLC 患者，单纯 CIRT 治疗是安全有效的。
