【摘 要】
：
It has been more than one decade since we started carbon ion radiation therapy (CIRT) for non-small cell lung cancer(NSCLC) November in 1994.From 1994 to 1999, we conducted a phase Ⅰ/Ⅱ clinical trial
【机 构】
：
Research Center for Charged Particle Therapy, National Institute of Radiological Sciences (NIRS) Jap
【出 处】
：
BITs 3rd Annual World Cancer Congress-2012(2012第五届世界癌症大会)
论文部分内容阅读
It has been more than one decade since we started carbon ion radiation therapy (CIRT) for non-small cell lung cancer(NSCLC) November in 1994.From 1994 to 1999, we conducted a phase Ⅰ/Ⅱ clinical trial for stage Ⅰ NSCLC with CIRT and demonstrated an optimal dose of 90GyE in 18 fractions over 6 weeks and 72GyE in 9 fractions over 3 weeks for achieving more than 90% local control with minimal pulmonary damage.In the following phase Ⅱ study from 1999 to 2003, the total dose was fixed at 72GyE in 9 fractions over 3 weeks and at 52.8GyE for stage IA and at 60GyE for stage 1B in 4 fractions over 1 week.Targets were irradiated from four oblique directions.A respiratory-gated irradiation system was used for all irradiation sessions.On these two phase Ⅱ schedules combined, the 5-year local control rate for 131 primary tumors of 129 patients was 91.5%.The local control rate for T1 and T2 tumors was 96.3% and 84.7%, respectively.While there was significant difference in control rate between T1 and T2, there was no significant difference in histology between squamous and non-squamous type.The 5-year cause-specific survival rate of the patients was 67.0% (IA: 84.4, IB: 43.7), and their overall survival was 45.3% (IA: 53.9, 1B: 34.2).No adverse effects greater than grade Ⅲ occurred in the lung.In this way, the treatment period and fractionation were shortened and lessened from 18 fractions over 6 weeks to 9 fractions over 3 weeks and further to 4 fractions over one week.Finally it reached a single-dose.Since 2003, 222 patients have already been treated with CIRT in single-dose increasing 28, 32, 34, 36, 38, 40, 42, 44,46, 48 and 50 GyE.Compared with the previous fractionation regimen,CIRT in single-dose is demonstrating low morbidity and high QOL.The 5-year local control rate of 145 tumors with doses more than 36GyE was higher than 80%.The 5-year cause-specific and overall survival rate of 145 patients w were70.9% and 53.9% respectively.Of the whole evaluate, we will finally recommend that CIRT in single-dose,50 GyE is best for the treatment for the peripheral type of stage Ⅰ NSCLC.
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