TY - JOUR
T1 - Carbon ion radiotherapy for stage I non-small cell lung cancer
AU - Miyamoto, Tadaaki
AU - Yamamoto, Naoyoshi
AU - Nishimura, Hideki
AU - Koto, Masashi
AU - Tsujii, Hirohiko
AU - Mizoe, Jun Etsu
AU - Kamada, Tadashi
AU - Kato, Hirotoshi
AU - Yamada, Shigeru
AU - Morita, Shinroku
AU - Yoshikawa, Kyosan
AU - Kandatsu, Susumu
AU - Fujisawa, Takehiko
AU - Owada, H.
AU - Kimura, H.
AU - Kuriyama, T.
AU - Koike, T.
AU - Kodama, T.
AU - Kobayashi, K.
AU - Kondo, T.
AU - Goya, T.
AU - Takagi, K.
AU - Tuchiya, R.
AU - Nakano, T.
AU - Nishiwaki, Y.
AU - Higashiyama, M.
AU - Yamashita, T.
N1 - Funding Information:
We are indebted to Suho Sakata, PhD, and Hinako Toyama, PhD, at NIRS, Haruo Mikami, PhD, and Motoi Murata, PhD, at Chiba Cancer Center for statistical analysis and data management. Thanks are also due to Mr Sinya Kanekio, a Waseda University student, for his help in statistical analysis and to Ms Kazuko Nakajima for her secretarial support. We are indebted to Yoichiro Umegaki, MD, Masao Oto, MD, and Kunio Okuda, MD, for their critical review of this article, and Yoshisuke Matsuoka, MD, Hiroshi Tsuji, MD, Yasuo Hirao, PhD, and Kozo Morita, MD, for their constant support. The late Yutaka Yamaguchi, MD, the former chief of the Working Group of Lung Cancer, is warmly acknowledged for his constant encouragement. This study was supported by the research project with heavy ions at NIRS-HIMAC, National Institute of Radiological Sciences.
PY - 2003/2/1
Y1 - 2003/2/1
N2 - 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.
AB - 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.
KW - Carbon beam
KW - Phase I/II
KW - Radical radiotherapy
KW - Stage I non-small cell lung cancer
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U2 - 10.1016/S0167-8140(02)00367-5
DO - 10.1016/S0167-8140(02)00367-5
M3 - Article
C2 - 12648784
AN - SCOPUS:0037296493
VL - 66
SP - 127
EP - 140
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
SN - 0167-8140
IS - 2
ER -