Abstract
It has been approximately two decades since we started performing carbon ion radiation therapy (C-ion RT) for non-small cell lung cancer (NSCLC). In 1994, we started conducting clinical trials using the dose-escalation method to determine the optimal dose of radiation. The additional purpose was to develop accurate, reliable, and safe irradiation techniques for C-ion RT.
In a subsequent phase II study of peripheral type stage I NSCLC, the total dose was fixed at 72 GyE in 9 fractions over 3 weeks and at 52.8 GyE for stage IA and at 60 GyE for stage 1B in 4 fractions over 1 week. In this way, the treatment period and fractionation were shortened and decreased from 18 fractions over 6 weeks to 9 fractions over 3 weeks and then further to 4 fractions over 1 week. Finally we were able to administer treatment as a single fraction.
For early-stage central- or hilar-type NSCLC, we conducted trials to identify the best way to preserve the pulmonary function with radical treatment. The prescribed dose for early central squamous cell carcinoma ranged from 54 to 61.2 GyE in nine fractions. For tumors close the hilus, we used 68.4 GyE/12 fractions, with planned target shrinking.
In addition, we also tried to treat locally advanced lung cancer, regional lymph node metastases that occurred after C-ion RT for clinical stage I cancer, and metastatic lung tumors.
This report describes the techniques and clinical trials that have been undertaken at the NIRS and describes the results of the current study. The use of C-ion RT for mediastinal or hilar lymph node metastases and metastatic lung tumors is described in Chap. 22.
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Yamamoto, N., Nakajima, M. (2014). Lung Cancer. In: Tsujii, H., Kamada, T., Shirai, T., Noda, K., Tsuji, H., Karasawa, K. (eds) Carbon-Ion Radiotherapy. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54457-9_21
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