Evaluation of the effect of carbon ion radiotherapy on limited-stage small cell lung cancer
Objective To observe the safety and efficacy of carbon ion radiotherapy combined with concurrent chemotherapy and followed prophylactic cranial irradiation for limited.Methods A total of 22 pathologically confirmed limited-stage small cell lung cancer patients admitted to Gansu Wuwei Tumor Hospital from May 27,2020 to April 13,2023 were se-lected as the study objects,the prescribed dose of carbon ions was 72 Gy(RBE)/12 fractions.Carbon ion radiotherapy was used in all patients concurrent with EP regimen chemotherapy.Patients who achieved complete or partial response after carbon ion therapy were given prophylactic cranial irradiation.The level of neuron specific enolase,treatment-related toxic-ity,1-year and 2-year local control rate,progression-free survival rate,and overall survival rate were observed before and after treatment.Results Preliminary result of this pilot study showed 21 of the 22 patients completed concurrent chemo-radiotherapy.One patient did not receive chemotherapy due to comorbidity of cardiorenal syndrom,the other patients were well tolerated.The average NSE levels of 22 patients before and after treatment were(30.73±13.27)and(9.56±3.94)ng/ml,respectively,with statistically significant differences,t=7.168,P＜0.001.Follow-up period was 5-35 months.One patient developed multiple brain metastasis who refused prophylactic cranial irradiation 10 months after treatment.1-year local control rate was 100.00％and 2-year local control rate was 92.31％.The 1-year and 2-year survival rates were 94.12％and 84.71％,and the 1-year and 2-year progression-free survival rates were 94.74％and 77.73％,respectively.Adverse reactions related to carbon ion therapy included radiation pneumonia(9 cases of grade 1 and 2 cases of grade 2),esophagitis(4 cases of grade 1),and skin reaction(1 case of grade 1),all of which were grade 1 and 2 toxicities.Conclu-sion Carbon ion radiotherapy with concurrent chemotherapy and prophylactic cranial irradiation for limited-stage small cell lung cancer is effective and feasiblity,with tolerable side effects and good local control rate and survival rate,but fur-ther evaluation with more cases and longer follow-up is still needed.
carbon ion therapylimited-stage small cell lung cancersecurityconcurrent radiochemotherapyprophylactic cranial irradiation
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