Metastatic Lung Tumors and Lymph Nodes

Abstract

The clinical results after carbon ion radiotherapy (C-ion RT) metastatic lung tumors and lymph node metastases that occurred after C-ion RT for clinical stage I non-small lung cancer (NSCLC) were evaluated and compared to surgery.

One hundred and sixteen lung metastatic lesions in 91 patients were treated with C-ion RT at our institute from April 1997 to February 2011. After a median follow-up period of 2.3 years (range, 0.3–13.1 years), the statistical overall survival rate and local control rate were 71.2 and 91.9 % at 2 years after treatment, respectively. Treatment-related side effects were not a clinical problem. When classified by the primary organ, there were 49 cases of lung cancer, 20 cases of colorectal cancer, and 22 cases of other cancers. The overall survival rate and local control rate for cases with lung metastasis from lung cancer at 2 years after treatment were 81.5 and 92.4 %, respectively, and were 65.0 and 92.0 % for lung metastasis from colorectal cancer. C-ion RT for the metastatic lung tumors is safe, and the therapeutic effect is comparable to the outcome from reported surgical resections.

With regard to the nodal metastases from lung cancer, 36 patients were treated between January 2000 and December 2010. The 36 metastatic lesions were treated by carbon ion beam irradiation alone using a total dose of 48.0 GyE in 12 fractions over 3 weeks. The statistical 3-year overall survival rate of the 36 patients was 52.9 % with a median observation period of 13.5 months (range, 2.9–114.8 m). The 3-year local control rate was 100 %. The toxicities to the skin and lungs caused by C-ion RT were assessed according to the NCI-CTC (early) and RTOG/EORTC (late). No adverse events greater than grade 2 were detected among the early and late reactions.