10 - Scanning Beam Proton Therapy versus Photon IMRT For Stage III Lung Cancer: comparison of dosimetry, toxicity and outcomes
Year: 2019
Type: other
Abstract: Purpose: There is limited clinical data on scanning-beam proton therapy (SPT) in treating locally-advanced lung cancer, as most published literature is with passive-scatter technology. There is increasing interest in whether the dosimetric advantages of SPT compared with photon therapy can translate into superior clinical outcomes. We present our experience of SPT and photon intensity-modulated radiation therapy (IMRT) with real-life dosimetry, and outcomes in patients with stage III non-small cell lung cancer (NSCLC). Methods: Patients with stage III NSCLC treated at our center between 2013-May 2018 were identified in compliance with an IRB-approved study (64 patients=34 SPT +30 IMRT). Most proton patients were treated with pencil-beam-scanning (28/34), 6/34 with uniform-scanning. Fisheru2019s exact test, Chi-square test, and Mann-Whitney test were used to compare groups. All tests were two-sided.Results: Patient characteristics are in Table 1. Mean dose to lung, heart, and esophagus were lower in the SPT group, with most benefit in the low dose region (Table 2). Esophagitis and dermatitis grades were not different between the two groups (Table 3). Grade 2+ pneumonitis rate was 21% in the SPT group and 40% in the IMRT group (p=0.1). Overall survival and progression free-survival were not different between SPT and IMRT. Conclusions: We report our experience with scanning beam proton therapy and photon IMRT in stage III NSCLC, showing lower dose to normal organs (lungs, heart, esophagus) with SPT than IMRT. There is no statistically significant difference in toxicity rates or survival, although there may be a trend towards lower rates of pneumonitis.
Author: Jing Zeng
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4213226178