Preliminary Safety and Efficacy of Proton Plus Carbon-Ion Radiotherapy With Concurrent Chemotherapy in Limited-Stage Small Cell Lung Cancer

Ning-Yi Ma; Ning-Yi Ma; Ning-Yi Ma; Jian Chen; Jian Chen; Jian Chen; Xue Ming; Xue Ming; Xue Ming; Guo-Liang Jiang; Guo-Liang Jiang; Guo-Liang Jiang; Jiade J. Lu; Jiade J. Lu; Jiade J. Lu; Kai-Liang Wu; Kai-Liang Wu; Kai-Liang Wu; Jingfang Mao; Jingfang Mao; Jingfang Mao

doi:10.3389/fonc.2021.766822

Frontiers in Oncology (Nov 2021)

Preliminary Safety and Efficacy of Proton Plus Carbon-Ion Radiotherapy With Concurrent Chemotherapy in Limited-Stage Small Cell Lung Cancer

Ning-Yi Ma,
Ning-Yi Ma,
Ning-Yi Ma,
Jian Chen,
Jian Chen,
Jian Chen,
Xue Ming,
Xue Ming,
Xue Ming,
Guo-Liang Jiang,
Guo-Liang Jiang,
Guo-Liang Jiang,
Jiade J. Lu,
Jiade J. Lu,
Jiade J. Lu,
Kai-Liang Wu,
Kai-Liang Wu,
Kai-Liang Wu,
Jingfang Mao,
Jingfang Mao,
Jingfang Mao

Affiliations

Ning-Yi Ma: Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China
Ning-Yi Ma: Department of Radiation Oncology, Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
Ning-Yi Ma: Department of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
Jian Chen: Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China
Jian Chen: Department of Radiation Oncology, Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
Jian Chen: Department of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
Xue Ming: Department of Radiation Oncology, Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
Xue Ming: Department of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
Xue Ming: Department of Radiation Physics, Shanghai Proton and Heavy Ion Center, Shanghai, China
Guo-Liang Jiang: Department of Radiation Oncology, Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
Guo-Liang Jiang: Department of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
Guo-Liang Jiang: Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Fudan University, Shanghai, China
Jiade J. Lu: Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China
Jiade J. Lu: Department of Radiation Oncology, Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
Jiade J. Lu: Department of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
Kai-Liang Wu: Department of Radiation Oncology, Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
Kai-Liang Wu: Department of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
Kai-Liang Wu: Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Fudan University, Shanghai, China
Jingfang Mao: Department of Radiation Oncology, Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China
Jingfang Mao: Department of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
Jingfang Mao: Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Fudan University, Shanghai, China

DOI: https://doi.org/10.3389/fonc.2021.766822
Journal volume & issue: Vol. 11

Abstract

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ObjectivesThis study aimed to investigate the tolerance and effect of proton plus carbon-ion radiotherapy with concurrent chemotherapy in limited-stage small cell lung cancer using the pencil beam scanning technique.Materials and MethodsFrom March 2017 to April 2020, 25 patients with limited-stage small cell lung cancer treated with combined proton and carbon-ion radiotherapy were analyzed. The primary lesions and involved lymph nodes were irradiated using 2–4 portals. Proton and sequential carbon-ion beams were delivered with a median dose of 67.1 (range, 63–74.8) GyE as fraction doses of 2.0–2.2 GyE with proton beams in 20–23 fractions and 3.0–3.8 GyE with carbon ions in 5–8 fractions. Chemotherapy was delivered concurrently with radiotherapy in all patients.ResultsAt the last follow-up, the 2-year overall and locoregional progression-free survival rates were 81.7% and 66.7%, respectively. Radiochemotherapy was well tolerated, with grade 1, 2, and 3 acute toxicities occurring in 12.0%, 68.0%, and 20.0% of patients, respectively. All grade 3 acute toxicities were hematologically related changes. One patient experienced grade 3 acute non-hematological toxicity in the esophagus, and one other patient had grade 3 bronchial obstruction accompanied by obstructive atelectasis as a late side effect.ConclusionProton plus carbon-ion radiotherapy using pencil beam scanning yielded promising survival rates and tolerability in patients with limited-stage small cell lung cancer. A prospective clinical study is warranted to validate the therapeutic efficacy of particle radiotherapy in combination with chemotherapy in limited-stage small cell lung cancer.

Published in Frontiers in Oncology

ISSN: 2234-943X (Online)
Publisher: Frontiers Media S.A.
Country of publisher: Switzerland
LCC subjects: Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: https://www.frontiersin.org/journals/oncology/

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