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. Author manuscript; available in PMC: 2019 Jun 20.

Published in final edited form as: J Clin Oncol. 2018 Jan 2;36(18):1813–1822. doi: 10.1200/JCO.2017.74.0720

A, Cumulative incidence of radiation pneumonitis (RP) plus that of local failure (LF) among patients who were randomized and treated according to time of enrollment (early=before the midpoint of the trial September 2011 [blue lines, median follow-up time 29 months]; later=after the midpoint [red lines, median follow-up 23 months]). Patients in the “later” group had lower rates of RP+LF. Similar results were found when patients were analyzed by intent-to-treat or by treatment received (not shown). IMRT, intensity-modulated (photon) therapy; PSPT, passive scattering proton therapy. B, Cumulative incidence of RP among patients among patients who were randomized and treated according to time of enrollment. In the IMRT group, RP occurred in both the early and later enrollees; however, in the PSPT group, RP occurred only among the early enrollees. The results suggest the existence of a “learning curve” for the delivery of PSPT, with corresponding improvements in PSPT over the course of the trial.

A, Cumulative incidence of radiation pneumonitis (RP) plus that of local failure (LF) among patients who were randomized and treated according to time of enrollment (early=before the midpoint of the trial September 2011 [blue lines, median follow-up time 29 months]; later=after the midpoint [red lines, median follow-up 23 months]). Patients in the “later” group had lower rates of RP+LF. Similar results were found when patients were analyzed by intent-to-treat or by treatment received (not shown). IMRT, intensity-modulated (photon) therapy; PSPT, passive scattering proton therapy. B, Cumulative incidence of RP among patients among patients who were randomized and treated according to time of enrollment. In the IMRT group, RP occurred in both the early and later enrollees; however, in the PSPT group, RP occurred only among the early enrollees. The results suggest the existence of a “learning curve” for the delivery of PSPT, with corresponding improvements in PSPT over the course of the trial.