Clinical outcomes of proton beam therapy for inoperable stage I-IIA non-small cell lung cancer: Japanese nationwide registry study

IF 4.9 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology Pub Date : 2025-03-22 DOI:10.1016/j.radonc.2025.110868

Masaki Nakamura , Kazushi Maruo , Masao Murakami , Takashi Ogino , Hiromitsu Iwata , Masatoshi Nakamura , Hitoshi Tatebe , Takahiro Waki , Sunao Tokumaru , Miyako Satouchi , Kimihiro Shimizu , Takayuki Hashimoto , Hidefumi Aoyama , Hideyuki Harada

{"title":"Clinical outcomes of proton beam therapy for inoperable stage I-IIA non-small cell lung cancer: Japanese nationwide registry study","authors":"Masaki Nakamura , Kazushi Maruo , Masao Murakami , Takashi Ogino , Hiromitsu Iwata , Masatoshi Nakamura , Hitoshi Tatebe , Takahiro Waki , Sunao Tokumaru , Miyako Satouchi , Kimihiro Shimizu , Takayuki Hashimoto , Hidefumi Aoyama , Hideyuki Harada","doi":"10.1016/j.radonc.2025.110868","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>Radiotherapy is the standard treatment for unresectable stage I-IIA non-small cell lung cancer (NSCLC). One treatment option within radiotherapy is proton beam therapy (PBT). Currently, a prospective observational study is being conducted at all proton therapy centers in Japan as part of a proton beam all-case registry. This study aimed to evaluate the outcomes of PBT for inoperable stage I-IIA NSCLC.</div></div><div><h3>Methods</h3><div>We included patients with stage I-IIA (UICC 8th) NSCLC who had started PBT between May 2016 and June 2020. Overall survival (OS), progression-free survival (PFS), cumulative incidence of local failure (LF), and adverse events were evaluated. Prognostic factors were compared using log-rank test and Cox proportional hazards model. The cumulative incidence curves were compared using Gray’s test.</div></div><div><h3>Results</h3><div>A total of 309 patients were evaluated. The median follow-up period was 47 months, calculated using the reverse Kaplan–Meier method. The 3/5-year OS was 62.7 %/47.7 %, PFS was 52.9 %/40.0 %, and LF was 14.4 %/22.1 %. According to the stage, 3-year OS, PFS, and LF were 69.6 %, 58.7 %, 13.3 %, respectively, for stage IA; 55.3 %, 41.6 %, 15.6 %, respectively, for stage IB; 33.9 %, 41.5 %, 25.6 %, respectively, for stage IIA. Female sex and good performance status, absence of interstitial pneumonia, absence of double cancer, and T1 stage were favorable prognostic factors for OS in a multivariate analysis. Grade ≥ 4 adverse events were not observed.</div></div><div><h3>Conclusion</h3><div>This study provided real-world treatment outcomes of PBT for inoperable stage I-IIA NSCLC in Japan.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"207 ","pages":"Article 110868"},"PeriodicalIF":4.9000,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiotherapy and Oncology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S016781402500163X","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

Radiotherapy is the standard treatment for unresectable stage I-IIA non-small cell lung cancer (NSCLC). One treatment option within radiotherapy is proton beam therapy (PBT). Currently, a prospective observational study is being conducted at all proton therapy centers in Japan as part of a proton beam all-case registry. This study aimed to evaluate the outcomes of PBT for inoperable stage I-IIA NSCLC.

Methods

We included patients with stage I-IIA (UICC 8th) NSCLC who had started PBT between May 2016 and June 2020. Overall survival (OS), progression-free survival (PFS), cumulative incidence of local failure (LF), and adverse events were evaluated. Prognostic factors were compared using log-rank test and Cox proportional hazards model. The cumulative incidence curves were compared using Gray’s test.

Results

A total of 309 patients were evaluated. The median follow-up period was 47 months, calculated using the reverse Kaplan–Meier method. The 3/5-year OS was 62.7 %/47.7 %, PFS was 52.9 %/40.0 %, and LF was 14.4 %/22.1 %. According to the stage, 3-year OS, PFS, and LF were 69.6 %, 58.7 %, 13.3 %, respectively, for stage IA; 55.3 %, 41.6 %, 15.6 %, respectively, for stage IB; 33.9 %, 41.5 %, 25.6 %, respectively, for stage IIA. Female sex and good performance status, absence of interstitial pneumonia, absence of double cancer, and T1 stage were favorable prognostic factors for OS in a multivariate analysis. Grade ≥ 4 adverse events were not observed.

Conclusion

This study provided real-world treatment outcomes of PBT for inoperable stage I-IIA NSCLC in Japan.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Radiotherapy and Oncology 医学-核医学

CiteScore

10.30

自引率

10.50%

发文量

2445

审稿时长

45 days

期刊介绍： Radiotherapy and Oncology publishes papers describing original research as well as review articles. It covers areas of interest relating to radiation oncology. This includes: clinical radiotherapy, combined modality treatment, translational studies, epidemiological outcomes, imaging, dosimetry, and radiation therapy planning, experimental work in radiobiology, chemobiology, hyperthermia and tumour biology, as well as data science in radiation oncology and physics aspects relevant to oncology.Papers on more general aspects of interest to the radiation oncologist including chemotherapy, surgery and immunology are also published.