Carbon-ion radiotherapy for non-small cell lung cancer with interstitial lung disease: a retrospective analysis

Radiation Oncology

Takehiko Fujisawa¹  Kenji Tsushima²  Koichiro Tatsumi²  Yuji Tada²  Makoto Anzai³  Tadaaiki Miyamoto⁴  Kazuhiko Hayashi⁴  Wataru Takahashi⁴  Mio Nakajima⁴  Masataka Karube⁴  Naoyoshi Yamamoto⁴  Hiroshi Tsuji⁴  Tadashi Kamada⁴  Daniel K Ebner⁴ 

[1] Chiba Foundation for Health Promotion and Disease Prevention;Department of Respirology, Graduate School of Medicine, Chiba University;Kansai Rosai Hospital;National Institute of Radiological Sciences Hospital, National Institutes for Quantum and Radiological Sciences and Technology;

关键词: Carbon ion radiotherapy;    Lung cancer;    Interstitial lung disease;    Radiotherapy;    Radiation pneumonitis;   

DOI  :  10.1186/s13014-017-0881-1

来源: DOAJ

【 摘 要 】

Abstract Background Lung cancer is frequently complicated by interstitial lung disease (ILD). Treatment protocols for lung cancer patients with ILD have not been established; surgery, chemotherapy, and radiotherapy can all cause acute exacerbation of ILD. This study evaluated the toxicity and efficacy of carbon ion radiotherapy (CIRT) in patients with non-small cell lung cancer (NSCLC) and ILD. Methods Between June 2004 and November 2014, 29 patients diagnosed with NSCLC and ILD were treated with CIRT. No patient was eligible for curative surgery or conventional radiotherapy secondary to ILD. Owing to prior symptomology, radiation pneumonitis (RP) and symptom progression pre- and post-treatment were evaluated. The relationships between RP and clinical factors were investigated. Results Twenty-eight men and one woman, aged 62 to 90 years old, were followed for 2.7–77.1 months (median: 22.8 months). Single-grade symptomatic progression (grade 2–3) was observed in 4 patients, while 1 patient experiencedtwo-grade progression. Two patients experienced radiation-induced acute exacerbation. Local control at 3 years was 63.3% (72.2% for stage I disease); survival at 3 years was 46.3% (57.2% for stage I disease). Eighteen patients had died by the time of this writing, 10 of lung cancer progression. Radiation pneumonitis post-treatment progression correlated with dosimetric factors of the lungs (V5, V10) and a low pre-treatment serum surfactant protein-D. Conclusions We found that CIRT may be useful as a low-risk, curative option for NSCLC patients with ILD, a population that is typically ineligible for conventional therapy. The DVH analysis showed that minimizing the low-dose region is important for reducing the risk of severe RP. Trial registration NIRS-9404 . Registered 1 March 1994.

【 授权许可】

Unknown