Carbon ion radiotherapy for stage I non-small cell lung cancer

Tadaaki Miyamoto, Naoyoshi Yamamoto, Hideki Nishimura, Masashi Koto, Hirohiko Tsujii, Jun Etsu Mizoe, Tadashi Kamada, Hirotoshi Kato, Shigeru Yamada, Shinroku Morita, Kyosan Yoshikawa, Susumu Kandatsu, Takehiko Fujisawa, H. Owada, H. Kimura, T. Kuriyama, T. Koike, T. Kodama, K. Kobayashi, T. KondoT. Goya, K. Takagi, R. Tuchiya, T. Nakano, Y. Nishiwaki, M. Higashiyama, T. Yamashita

Research output: Contribution to journalArticlepeer-review

160 Citations (Scopus)

Abstract

Background and purpose: Heavy ion radiotherapy is a promising modality because of its excellent dose localization and high biological effect on tumors. Using carbon beams, a dose escalation study was conducted for the treatment of stage I non-small cell lung cancer (NSCLC) to determine the optimal dose. Materials and methods: The first stage phase I/II trial using 18 fractions over 6 weeks for 47 patients and the second one using nine fractions over 3 weeks for 34 patients were conducted by the dose escalation method from 59.4 to 95.4 Gray equivalents (GyE) in incremental steps of 10% and from 68.4 to 79.2 GyE in 5% increments, respectively. The local control and survival rates were obtained using the Kaplan-Meier method. Results: Radiation pneumonitis at grade III occurred in three of 81 patients, but they fully recovered. This was not a dose-limiting factor. The local control rates in the first and second trials were 64% and 84%, respectively. The total recurrence rate in both trials was 23.2%. The infield local recurrence in the first trial was significantly dependent on carbon dose. The doses greater than 86.4 GyE at 18 fractions and 72 GyE at nine fractions achieved a local control of 90% and 95%, respectively. The 5 year overall and cause-specific survivals in 81 patients were 42% and 60%, respectively. Conclusions: With our dose escalation study, the optimum safety and efficacy dose of carbon beams was determined. Carbon beam therapy attained almost the same results as surgery for stage I NSCLC although this was a I/II study.

Original languageEnglish
Pages (from-to)127-140
Number of pages14
JournalRadiotherapy and Oncology
Volume66
Issue number2
DOIs
Publication statusPublished - 2003 Feb 1

Keywords

  • Carbon beam
  • Phase I/II
  • Radical radiotherapy
  • Stage I non-small cell lung cancer

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging

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