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WESTPORT, Dec 10 (Reuters Health) - Patients with medically inoperable early-stage non-small-cell lung cancer can successfully and safely be treated with proton-beam radiotherapy, and the results compare well with those from previous studies of conventional x-ray therapy. These findings are from a prospective study carried out by US and German researchers.
Dr. David A. Bush, from the Loma Linda University Medical Center in California, and colleagues there and in Germany explain that x-ray radiation (photon) therapy has been used to treat patients with early-stage but inoperable lung cancer. They note, however, that in patients with severe pulmonary disease, treatment with high-dose irradiation may exacerbate pulmonary defects.
Because proton beams can be targeted more accurately than x-rays, the dose administered can be significantly reduced to help prevent pulmonary damage. In the present study, the authors used proton-beam radiotherapy to treat 37 patients with stage I non-small cell lung cancer, 2 with stage II cancer and 8 with stage IIIa cancer.
Nineteen patients were assigned to proton-beam radiation only and 18 to photons and protons. Each group received biologically similar doses of radiation and participants were followed up for a median of 14 months.
The authors report in the November issue of Chest that the "...disease-free survival [rate] at 2 years for the entire group was 63%; for stage I patients, [it] was 86%." They also found that "[l]ocal disease control was 87%."
According to the paper, pneumonitis developed in two patients treated in the proton/photon arm of the trial, but it was resolved by a course of oral steroids. There were no other significant toxicities. Dr. Bush's team concludes that the preliminary results "...indicate that proton-beam radiotherapy can be used safely in this group of patients."
Chest 1999;116:1313-1319.
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