Karube M, et al. – Carbon–ion radiotherapy (CIRT) was explored for in–field recurrence of stage I non–small cell lung cancer (NSCLC) initially treated with CIRT. With the help of the findings acquired, researchers outlined CIRT for stage I NSCLC local recurrence as an acceptable definitive re–treatment.

Methods

• Patients initially treated for stage I NSCLC with CIRT and relapsed in-field were candidates, from January 2007 to March 2014.
• An analysis was performed for overall survival (OS) rate, local control (LC) rate, progressive free survival (PFS) rate, dose to the lungs and skin, and adverse effects.

Results

• Eligibility criteria were met by twenty-nine patients.
• In addition, median age at re-irradiation was 74 years (range 53–90).
• Researchers suggested that median observation period from the first day of re-irradiation was 29 months (4–88 months).
• As initial treatment, median prescribed dose was 46.0 Gy (RBE) and 66.0 Gy (RBE) in 12 fractions as re-irradiation.
• 69.0% (95% CI: 50.3–83.0), 66.9% (95% CI: 47.5–81.9), and 51.7% (95% CI: 34.1–68.9) were two-year OS, LC, and PFS rates after re-irradiation.
• According to results, median skin maximum dose was 53.8 Gy (RBE) (range 4.4–103.1) and median of mean lung dose was 7.3 Gy (RBE) (range 2.6–14.0).
• No severer than grade 2 adverse effects except one (3.4%) grade 3 bacterial pneumonia, which was not considered radiation-induced, was noted.