Abstract：
To investigate the toxicity and survival outcomes of proton and carbon ion radiotherapy for patients with operable early-stage lung cancer who are eligible for lobectomy.
This multicenter nationwide prospective cohort study included patients with operable early-stage lung cancer. Proton and carbon ion radiotherapy was performed according to the schedule stipulated in the unified treatment policy. Progression-free survival (PFS), overall survival (OS) and treatment-related toxicities were evaluated.
A total of 274 patients were enrolled and included in efficacy and safety analyses. The most common tumor type was adenocarcinoma (44 %), while 105 cases (38 %) were not histologically confirmed or diagnosed clinically. Overall, 250 (91 %) of the 274 patients had tumors that were peripherally situated, while 138 (50 %) and 136 (50 %) patients were treated by proton and carbon ion radiotherapy, respectively. The median follow-up time for all censored patients was 42.8 months (IQR 36.7-49.0). Grade 3 or severe treatment-related toxicity was observed in 4 cases (1.5 %). Three-year PFS was 80.5 % (95 % CI: 75.7 %-85.5 %) and OS was 92.5 % (95 % CI: 89.3 %-95.8 %). Pathological confirmation and clinical stage were factors significantly associated with PFS, while tumor location and particle-ion type were not. Meanwhile, clinical stage was significantly associated with OS, but pathological confirmation, tumor location, and particle-ion type were not.
Particle therapy for operable early-stage lung cancer resulted in excellent 3-year OS and PFS in each subset. In this disease context, proton and carbon ion beam therapies are feasible alternatives to curative surgery.
This multicenter nationwide prospective cohort study included patients with operable early-stage lung cancer. Proton and carbon ion radiotherapy was performed according to the schedule stipulated in the unified treatment policy. Progression-free survival (PFS), overall survival (OS) and treatment-related toxicities were evaluated.
A total of 274 patients were enrolled and included in efficacy and safety analyses. The most common tumor type was adenocarcinoma (44 %), while 105 cases (38 %) were not histologically confirmed or diagnosed clinically. Overall, 250 (91 %) of the 274 patients had tumors that were peripherally situated, while 138 (50 %) and 136 (50 %) patients were treated by proton and carbon ion radiotherapy, respectively. The median follow-up time for all censored patients was 42.8 months (IQR 36.7-49.0). Grade 3 or severe treatment-related toxicity was observed in 4 cases (1.5 %). Three-year PFS was 80.5 % (95 % CI: 75.7 %-85.5 %) and OS was 92.5 % (95 % CI: 89.3 %-95.8 %). Pathological confirmation and clinical stage were factors significantly associated with PFS, while tumor location and particle-ion type were not. Meanwhile, clinical stage was significantly associated with OS, but pathological confirmation, tumor location, and particle-ion type were not.
Particle therapy for operable early-stage lung cancer resulted in excellent 3-year OS and PFS in each subset. In this disease context, proton and carbon ion beam therapies are feasible alternatives to curative surgery.
摘要：
目的：探讨质子和碳离子放疗对可手术的早期肺癌患者的毒性和生存结局。
方法：这项全国范围的多中心前瞻性队列研究纳入了可手术的早期肺癌患者。质子和碳离子放射治疗按统一治疗政策规定的时间表进行。无进展生存期（PFS），评估总生存期(OS)和治疗相关毒性.
结果：共纳入274例患者，并纳入疗效和安全性分析。最常见的肿瘤类型是腺癌（44%），而105例（38％）未经组织学证实或临床诊断。总的来说,274例患者中有250例（91%）的肿瘤位于外周，而138例（50%）和136例（50%）患者接受了质子和碳离子放射治疗，分别。所有截尾患者的中位随访时间为42.8个月（IQR36.7-49.0）。在4例（1.5％）中观察到3级或严重的治疗相关毒性。3年PFS为80.5%（95%CI：75.7%-85.5%），OS为92.5%（95%CI：89.3%-95.8%）。病理证实和临床分期是与PFS显著相关的因素,而肿瘤位置和粒子离子类型没有。同时,临床分期与OS显著相关,但是病理证实，肿瘤位置,和粒子离子类型不是。
结论：颗粒治疗可手术的早期肺癌在每个亚组中都能获得出色的3年OS和PFS。在这种疾病的背景下，质子和碳离子束疗法是治愈性手术的可行替代方案。
方法：这项全国范围的多中心前瞻性队列研究纳入了可手术的早期肺癌患者。质子和碳离子放射治疗按统一治疗政策规定的时间表进行。无进展生存期（PFS），评估总生存期(OS)和治疗相关毒性.
结果：共纳入274例患者，并纳入疗效和安全性分析。最常见的肿瘤类型是腺癌（44%），而105例（38％）未经组织学证实或临床诊断。总的来说,274例患者中有250例（91%）的肿瘤位于外周，而138例（50%）和136例（50%）患者接受了质子和碳离子放射治疗，分别。所有截尾患者的中位随访时间为42.8个月（IQR36.7-49.0）。在4例（1.5％）中观察到3级或严重的治疗相关毒性。3年PFS为80.5%（95%CI：75.7%-85.5%），OS为92.5%（95%CI：89.3%-95.8%）。病理证实和临床分期是与PFS显著相关的因素,而肿瘤位置和粒子离子类型没有。同时,临床分期与OS显著相关,但是病理证实，肿瘤位置,和粒子离子类型不是。
结论：颗粒治疗可手术的早期肺癌在每个亚组中都能获得出色的3年OS和PFS。在这种疾病的背景下，质子和碳离子束疗法是治愈性手术的可行替代方案。
