Preliminary clinical results after pencil beam scanning particle radiotherapy for stage Ⅰ non-small cell lung cancer / 中华放射医学与防护杂志

ABSTRACT

Objective To evaluate the safety and efficacy of proton and carbon-ion radiotherapy (RT) for stage Ⅰ non-small cell lung cancer (NSCLC) with pencil beam scanning technique.Methods From August 2014 to December 2015,10 patients with stage Ⅰ NSCLC who were inoperable or refused surgery were treated by proton +/-carbon-ion RT.Primary lesions were irradiated using 2-4 portals with 45-degree beams.A total dose of 50-70 GyE/10 fractions,60-64 GyE/15-16 fractions,and 66-72 GyE/22-24 fractions were administered to patients based on tumor location (4 peripheral,3 middle,and 3 central lesions,respectively).Results At the last follow-up in December 2016 with the median follow-up of 18.1 (11.9-28.1) months,local control was found in all patients per CT or PET/CT scanning(6 complete response,3 partial response,and 1 stable disease).However,2 patients with local control (1 partial response and 1 stable disease) experienced a distant failure at 8.7 and 24.9 months after RT,respectively.There was no RT-related Grade 3-5 toxicity in all patients.Grade 2 toxicities were only found in 2 patients (acute skin reaction and leucopenia,respectively).At 1,3-5 months after RT,the pulmonary function tests showed a slightly increase in FVC,FEV1 and DLCO-sb compared with those before RT without statistical significance (P ＞ 0.05).Conclusions The particle RT using pencil beam scanning technique was safe,and yielded encouraging outcome for patients with stage I NSCLC who were inoperable or refused surgery.Further follow-up and prospective clinical studies are warranted in the future.