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- W2895889676 abstract "Radiotherapy (RT) has an integral role in the management of locally advanced non-small cell lung cancer (NSCLC). Few studies have evaluated the use of pencil-beam proton radiotherapy. We examined the early clinical outcomes and treatment-related toxicities of intensity modulated proton (IMPT) and intensity modulated photon therapies (IMRT) in patients (pts) with locally advanced NSCLC. We conducted a single-institution retrospective study of pts diagnosed with locally advanced NSCLC between 2016 and 2018 who received definitive IMPT or IMRT with or without concurrent chemotherapy; in the IMPT group, 9 (43%) pts had prior thoracic RT (vs. 0% in the IMRT group). Patient and disease characteristics were summarized with comparative statistics by chi-squared tests. Locoregional recurrence-free (LRFS), distant metastasis-free (DMFS), and overall survival (OS) since diagnosis were estimated with the Kaplan-Meier Method and log-rank test. Short term (during and 3 months post-RT) and long term (>3 months) toxicities were recorded by CTCAE v4.03. We identified 42 locally advanced NSCLC pts including 21 pts (50%) treated with IMPT, and 21 pts (50%) treated with IMRT. IMPT pts were older than the IMRT pts (Mean 74.4 vs. 67.1 years, p=0.007 respectively). The IMPT group had more pts with oxygen-dependent COPD (19 vs. 0%, p=0.038). Nine (43%) IMPT pts had recurrent NSCLC treated with re-irradiation, whereas all IMRT pts were treated for a primary NSCLC (p=0.0001). Fewer IMPT pts received concurrent chemotherapy (43 vs. 86%, p=0.003 respectively). Median follow-up was 8.5 and 7.4 months for the IMPT and IMRT pts, respectively. At 1 year, pts treated with IMPT vs IMRT had comparable LRFS (86 vs. 77%, p=0.21), DMFS (75 vs. 65%, p=0.19), and OS (60 vs. 56%, p=0.80 respectively). There were no differences in short-term grade 3 or 4 toxicities between the IMPT and IMRT groups (4 vs. 3 pts, p=0.68 respectively). There were no differences in long-term grade 3 or 4 toxicities (0 vs. 1 pt, p=0.23 respectively). There were no treatment-related grade 5 toxicities. Patients treated with IMPT were older, had higher rates of oxygen-dependent COPD, more often had recurrent disease requiring re-irradiation, and were less likely to receive concurrent chemotherapy compared to their counterparts treated by IMRT. Despite these disadvantages, our initial experience suggests that the patients treated with IMPT have comparable clinical outcomes and toxicity profiles when compared to patients treated with IMRT. The role of active beam-scanning proton radiotherapy in the management of primary and recurrent locally advanced NSCLC is promising and additional prospective studies are warranted." @default.
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- W2895889676 date "2018-11-01" @default.
- W2895889676 modified "2023-09-25" @default.
- W2895889676 title "Initial Clinical Outcomes in Patients with Locally Advanced Non-small Cell Lung Cancer Treated with Pencil-beam Proton Versus Intensity Modulated Photon Therapies: A Single-Institution Experience" @default.
- W2895889676 doi "https://doi.org/10.1016/j.ijrobp.2018.07.1930" @default.
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