Department of Radiation Oncology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Department of Radiology, School of Medicine, International University of Health and Welfare, Narita, Japan.
Thorac Cancer. 2021 May;12(9):1320-1327. doi: 10.1111/1759-7714.13896. Epub 2021 Mar 6.
To evaluate the long-term outcomes of high-dose (74 GyE) proton beam therapy (PBT) with concurrent chemotherapy for stage III non-small cell lung cancer (NSCLC).
Between July 2007 and March 2018, 45 patients with stage III NSCLC were treated with passive-scattering PBT of 74 GyE and concurrent chemotherapy. Among the 45 patients, the median age was 62 years (range 39-79 years) and 32 patients were men. The clinical stages were stage IIIA in 14 patients and stage IIIB in 31 patients. Thirty-six patients received chemotherapy consisting of cisplatin and vinorelbine.
The median follow-up time was 42.1 months (range 6.4-127.0 months) for all patients and 63.5 months (range 9.4-127.0 months) for the 12 survivors. The 3- and 5-year overall survival rates were 63.7% and 38.8%, respectively, and the median overall survival was 49.1 months. Over the follow-up period, disease recurrence was observed in 32 (71%) patients. The 3- and 5-year progression-free survival rates were 22.2% and 17.7%, respectively, with a median progression-free survival of 13.1 months. In-field control improved survival and the in-field control rate was better in patients with T0-3 tumors (p = 0.023) and stage IIIA/IIIB-N3 disease (p = 0.030). Dosimetric parameters of the heart and lung were not associated with survival. No grade 4 or 5 acute or late non-hematologic toxicities were observed.
Passive-scattering PBT of 74 GyE with chemotherapy showed favorable survival and a low incidence of severe adverse events in patients with stage III NSCLC.
评估高剂量（74GyE）质子束治疗（PBT）联合化疗治疗 III 期非小细胞肺癌（NSCLC）的长期疗效。
2007 年 7 月至 2018 年 3 月，45 例 III 期 NSCLC 患者接受了 74GyE 被动散射 PBT 联合化疗。45 例患者中，中位年龄为 62 岁（范围 39-79 岁），32 例为男性。临床分期为 14 例 IIIA 期和 31 例 IIIB 期。36 例患者接受了顺铂和长春瑞滨联合化疗。
所有患者的中位随访时间为 42.1 个月（范围 6.4-127.0 个月），12 例幸存者的中位随访时间为 63.5 个月（范围 9.4-127.0 个月）。3 年和 5 年总生存率分别为 63.7%和 38.8%，中位总生存期为 49.1 个月。随访期间，32 例（71%）患者出现疾病复发。3 年和 5 年无进展生存率分别为 22.2%和 17.7%，中位无进展生存期为 13.1 个月。肿瘤靶区（GTV）内控制改善了生存，T0-3 肿瘤（p=0.023）和 IIIA/IIIB-N3 期疾病（p=0.030）患者的 GTV 内控制率更好。心脏和肺部的剂量学参数与生存无关。未观察到 4 级或 5 级急性或迟发性非血液学毒性反应。
74GyE 被动散射 PBT 联合化疗治疗 III 期 NSCLC 患者的生存情况良好，严重不良事件发生率低。
