Evaluating the effectiveness and safety of combining proton plus carbon-ion radiotherapy with chemotherapy given at the same time in patients with limited-stage small-cell lung cancer.

This study investigated the effectiveness and safety of combining proton radiotherapy (PRT) plus carbon-ion radiotherapy (CIRT) with chemotherapy (CT) given at the same time in patients with limited-stage (LS) small cell lung cancer (SCLC). The data showed that PRT plus CIRT with CT given at the same time was effective with manageable side effects in these patients.

Lung cancer is the second most common cancer in the world. SCLC is an aggressive type of lung cancer that accounts for around 15% of all lung cancer diagnoses. In LS-SCLC, the cancer spread is limited to only one lung. CT combined with RT is the standard treatment for LS- SCLC.

PRT is a type of radiation therapy that uses a beam of special particles, called protons, to destroy cancer cells. PRT delivers the radiation dosage more precisely to the cancer cells and less to the surrounding healthy tissues. CIRT is a type of radiation therapy that uses carbon ions which are more active in killing cancer cells. However, there are few studies investigating the effectiveness and safety outcomes of combining PRT plus CIRT with CT given at the same time in patients with LS-SCLC.

This study involved 25 patients with LS-SCLC. Patients were treated with a combination of PRT plus CIRT with CT given at the same time. The average follow-up time was 19.2 months.

Overall, 95.8% of the patients were alive after 1 year and 81.7% were alive after 2 years. The average overall survival was not reached (exceeded the average follow-up time). 79% of the patients were alive without cancer worsening after 1 year and 41.2% were alive without cancer worsening after 2 years. The average survival without cancer worsening was 18.4 months.

83.1% of the patients were alive without cancer progression in and around the original site of disease after 1 year and 66.7% were alive after 2 years. The average survival without cancer progression in and around the original site of disease was not reached (exceeded the average follow-up time).

91.7% of the patients were alive without cancer spreading to distant organs after 1 year and 53.6% were alive without cancer worsening after 2 years. The average survival without cancer spreading to distant organs was 24.4 months.

PRT plus CIRT with chemotherapy was well tolerated in patients. No serious side effects were reported except in 1 patient who experienced inflammation of the esophagus lining.

This study concluded that PRT plus CIRT with CT given at the same time was effective with manageable side effects in patients with LS-SCLC.

This study was based on medical records. The sample size was very small. Larger studies are needed to validate the conclusions.