Small-spot intensity-modulated proton therapy and volumetric-modulated arc therapies for patients with locally advanced non-small-cell lung cancer: A dosimetric comparative study.
CONCLUSIONS: Small-spot IMPT improves cord, heart, and lung sparing compared to VMAT and achieves clinically acceptable plan robustness at least for the patients included in this study with motion amplitude less than 11 mm. Our study supports the usage of IMPT to treat some lung cancer patients. PMID: 30328674 [PubMed - as supplied by publisher]
ConclusionsVMAT is now widely available, and high-quality VMAT plans that incorporate cardiac substructures into the optimization process can provide overall improvements in dose to OARs and, in particular, substantial sparing of critical cardiac structures. IMPT provides some incremental dosimetric improvements beyond cardiac-optimized VMAT, the clinical significance of which remains uncertain.
ConclusionRITI can be induced in patients with NSCLC through upregulated IgG and/or IgM. RITI response was not associated with proton versus photon therapy or with clinical outcomes in this small cohort and should be examined in a larger cohort in future studies.
Conclusion We observed a significant increase in global lung inflammation bilaterally as measured by quantification of PG. However, no significant change in global lung inflammation was noted after proton therapy. Future larger studies are needed to determine whether this difference correlates with lower risks of radiation pneumonitis in NSCLC patients treated with proton therapy.
ConclusionsVMAT is now widely available, and high-quality VMAT plans that incorporate the cardiac substructures into the optimization process can provide overall improvements in doses to OARs and in particular substantial sparing of critical cardiac structures. IMPT provides some incremental dosimetric improvements beyond cardiac-optimized VMAT, the clinical significance of which remains uncertain.
Radiation therapy with concurrent chemotherapy is the recommended treatment for patients with locally advanced inoperable non-small cell lung cancer (NSCLC). Unfortunately, local and distant relapses are common, and the median survival time is only about 20 –30 months . Moreover, cardiopulmonary disease is common in such patients, which can make concurrent chemoradiotherapy difficult to tolerate . More effective modalities that allow systemic and local therapies to be combined can improve outcomes.
We report the early clinical outcomes and toxicities of intensity-modulated proton therapy (IMPT) vs. intensity-modulated radiation therapy (IMRT) in patients with locally-advanced NSCLC.
We explored spatial dose patterns associated with symptomatic radiation pneumonitis (RP) in patients with non-small-cell lung cancer given either intensity-modulated photon therapy or passive scattering proton therapy. A dose distribution analysis highlighted regional dose differences associated with both RP status and treatment modality, showing that regions spared with protons are complementary to those correlated with RP; these results can be useful for clinical practice and for designing future trials to minimize RP.
Idiopathic pulmonary fibrosis (IPF) is associated with fatal complications after radiotherapy (RT) for lung cancer patients; however, the role of proton therapy to reduce the incidence of life-threatening comp...
Abstract PURPOSE: To investigate the impact of unfavorable risk factors among patients with locally advanced nonsmall cell lung cancer (LA-NSCLC) treated with proton therapy (PT). MATERIAL AND METHODS: From May 2008 through July 2015, 90 consecutive patients with unresectable stage II-IV (oligometastatic) NSCLC were treated with PT. Unfavorable factors including age ≥80 years, stage IV, weight loss>10% in 3 months, performance status (PS) ≥2, FEV1
Opinion statementNon-small cell lung cancer (NSCLC) accounts for 85% of new lung cancer cases and has 5-year survival rates ranging from 92% in early-stage disease to as low as 13% in locally advanced cases. Radiation therapy is a key component in the treatment repertoire for NSCLC, where it is currently used alone or in combinations with chemotherapy and surgery. Despite the broad use of modern photon radiation techniques, as many as 25% of patients experience isolated locoregional recurrences, and toxicity has been proven to be a limiting factor in many cases. Proton beam therapy (PBT) has emerged as a potential solution...