Reviewer: James M. Metz, MD
Abramson Cancer Center of the University of Pennsylvania
Last Modified: May 22, 2007
Presenter: R. Komaki
Presenter's Affiliation: MD Anderson Cancer Center
Type of Session: Scientific
In the United States, concurrent chemotherapy and radiation therapy is standard for unresectable NSCLC. However, there is significantly increased toxicity with concurrent radiochemotherapy as opposed to sequential treatment. There has also been evidence that esophageal toxicity can be reduced when 2D versus 3D treatment planning is utilized, but still remains very high. Protons, due to the better dose distribution, may further reduce toxicity particularly in the era of concurrent chemotherapy and radiation therapy. This study reports on the acute toxicity in the initial patients treated with combined chemotherapy and proton therapy for NSCLC.
Materials and Methods
Although preliminary, this study makes an important contribution to the understanding of the combination of chemotherapy and proton therapy. Although a formal statistical comparison was not performed, acute toxicity of combined modality treatment was not increased by giving proton therapy to substantially higher doses then 3D conformal treatment. This is an important concept with moving forward with proton therapy. Proton therapy by itself will most likely not show significant improvements in survival. It is the combination of protons with chemotherapy and targeted biologic agents have the promise to make substantial impacts in overall survival and improve cancer care. We are currently very limited in our ability to combine a number of radiosensitizing chemotherapy agents due to the tolerance of normal tissues to radiation therapy. Proton therapy may completely change this paradigm.