Table 2.
Study descriptions advanced-stage NSCLC.
| Study (characteristics); location | Beam, energy, technique | Chemotherapy | Fractionation schedule, TTD/n or fr/OTT | Patient selection criteria/risk factors | Stage distribution |
|---|---|---|---|---|---|
| PROTON BEAM ONLY | |||||
| Bush et al. (26) (prospective, n = 37); U.S. Loma Linda | Proton Photon + proton PSc | No | 51 GyE/10 fr/2 weeks Photons, 45 Gy/25 fr + protons, 28.8 GyE/16 fr/5 weeks | NSCLC stage I–IIIA; medically inoperable/refused surgery | Stage I, 27; Stage II, 2; Stage IIIA, 8 |
| Shioyama et al. (27) (retrospective, n = 51); Japan, Tsukuba | Proton, 250 MeV, PSc (n = 33) Photon + proton (n = 18) | 6 patients prior chemotherapy (all advanced stages) | Median TD 76 Gy (range 49–93 Gy), median fr dose 3.0 Gy (range 2-6 Gy), median OTT 43 days | NSCLC, medically inoperable/refused surgery | Stage IA/IB, 9/19; Stage IIA/IIB, 3/6; Stage IIIA/IIIB, 8; Stage IV, 1, recurrent disease, 5. |
| Chang et al. (32) (phase II, n = 44), U.S., Houston | Proton, PSc | Concurrent, weekly carboplatin (2AUC) + paclitaxel (50 mg/m2) (n = 44). (neo) Adjuvant chemotherapy allowed (n = 19) | 74 GyE/37fr/7.5 weeks | NSCLC Stage III, Unresectable/medically inoperable, KPS 70-100, weight loss not >10% during <6months before diagnosis | Stage IIIA, 21; Stage IIIB, 23 |
| Nakayama et al. (31) (retrospective, n = 35), Japan, Tsukuba | Proton, 155-250 MeV, PSc | No | 77 GyE/35 fr/7 weeks (n = 13), 83.6 GyE/38 fr/7.5 weeks (n = 7), 72.6 GyE/22 fr/4.5 weeks (n = 6), 74 GyE/37 fr/7.5 weeks (n = 3), other (n = 6) | NSCLC Stage II/III, medically inoperable/refused surgery, EORTC PS 0–2, unsuitable for/refusal chemotherapy. Exclusion: pleural effusion, tumor close to stomach/esophagus | Stage IIA, 2; IIB, 3; Stage IIIA, 12, Stage IIIB, 18 |
| Xiang et al. (34) (prospective, n = 84), U.S. Houston | Proton, PSc | Concurrent, weekly carboplatin (2AUC) + paclitaxel (50mg/m2) (n = 84). (neo) Adjuvant chemotherapy allowed (n = 22) | 74 GyE/37/7.5 weeks | Stage III NSCLC, unresectable, availability of pre- and post-treatment PET-CT images | NR |
| Oshiro et al. (30) (retrospective, n = 57), Japan, Tsukuba | Proton, 200 MeV, PSc | No concurrent chemotherapy, induction chemotherapy: n = 14 | Median 74 GyE (50-84.5 GyE), median fr dose 2.0 GyE (2.0–6.6 GyE) | Stage III NSCLC | Stage IIIA, 24; Stage IIIB, 33 |
AUC, area under the curve; EORTC, European Organization for Research and Treatment of Cancer; KPS, Karnofsky Performance Status; NR, not reported; PS, performance score; PSc, passive scattering; TTD, total tumor dose.