Particle therapy for clinically diagnosed stage I lung cancer: Comparison with pathologically proven non-small cell lung cancer

Osamu Fujii, Yusuke Demizu, Naoki Hashimoto, Masaru Takagi, Kazuki Terashima, Masayuki Mima, Dongcun Jin, Fumiko Nagano, Kuniaki Katsui, Tomoaki Okimoto, Hiromitsu Iwata, Yasue Niwa, Tomohiro Yamashita, Takashi Akagi, Takashi Daimon, Ryohei Sasaki, Yoshio Hishikawa, Mitsuyuki Abe, Masao Murakami, Nobukazu Fuwa

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Abstract

Background. The purpose of the present study was to present the treatment outcomes of particle therapy for indeterminate pulmonary nodules (IPNs) diagnosed as stage I non-small cell lung cancer, including a comparative analysis involving pathologically proven lung cancer (PPLC). Material and methods. A total of 54 patients (57 lesions) who underwent particle therapy for IPNs were enrolled in this study. Median patient age was 76 (range 52-87) years. T-classification was: T1a, 30; T1b, 16; and T2a, 11. Particle therapy using protons or carbon ions was delivered at total doses of 52.8-80 Gy equivalent in 4-26 fractions. The PPLC cohort included 111 patients. Results. The median follow-up time was 41 (range 7-90) months. For all IPN patients, the three-year overall survival, progression-free survival, local control and distant progression-free survival rates were 90%, 72%, 94% and 79%, respectively. Grade 2 toxicities were radiation pneumonitis (19%), dermatitis (9%), rib fracture (2%), chest wall pain (2%) and neuropathy (2%). No ≥ grade 3 toxicities were observed. In univariate analysis, the IPN group showed significantly better survival relative to the PPLC group. However, after adjustment for baseline imbalances between these two groups in multivariate analysis, pathological confirmation did not correlate with survival. Conclusions. Particle therapy for IPNs provided favorable outcomes with minimal toxicities, which may be comparable to those for PPLC patients. Further studies are needed to clarify the optimal management of IPN patients.

Original languageEnglish
Pages (from-to)315-321
Number of pages7
JournalActa Oncologica
Volume54
Issue number3
DOIs
Publication statusPublished - Mar 1 2015
Externally publishedYes

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ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

Fujii, O., Demizu, Y., Hashimoto, N., Takagi, M., Terashima, K., Mima, M., Jin, D., Nagano, F., Katsui, K., Okimoto, T., Iwata, H., Niwa, Y., Yamashita, T., Akagi, T., Daimon, T., Sasaki, R., Hishikawa, Y., Abe, M., Murakami, M., & Fuwa, N. (2015). Particle therapy for clinically diagnosed stage I lung cancer: Comparison with pathologically proven non-small cell lung cancer. Acta Oncologica, 54(3), 315-321. https://doi.org/10.3109/0284186X.2014.974828