Neutron vs. photon radiation therapy for inoperable regional non-small cell lung cancer: Results of a multicenter randomized trial

Journal Article · Wed Oct 20 04:00:00 EDT 1993 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/0360-3016(93)90372-3· OSTI ID:54864

Koh, Wui-Jin; Laramore, G E; Griffin, T W ^[1]; Krall, J M ^[2]; Peters, L J; Maor, M H ^[3]; Burnison, C M ^[4]; Davis, L W ^[5]; Zink, S ^[6]

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1. Univ. of Washington Medical Center, Seattle, WA (United States)
2. American College of Radiology, Philadelphia, PA (United States)
3. Univ. of Texas MD Anderson Cancer Center, Houston, TX (United States)
4. UCLA, Los Angeles, CA (United States)
5. Emory Clinic, Atlanta, GA (United States)
6. National Cancer Institute, Bethesda, MD (United States)

To determine, with a prospective, multicenter randomized study, whether fast neutron radiation therapy improves the outcome for patients with non-small cell lung cancer, as compared to conventional photon radiotherapy. From September 1986 to March 1991, a total of 200 patients with inoperable regional non-small cell lung cancer were randomized to 20.4 Gy in 12 fractions with neutrons versus 66 Gy in 33 fractions with photons. Inoperable patients with Radiation Therapy Oncology Group Stages I, II, III, or IV (M0) disease, Karnofsky Performance Score {>=} 70, and who had received no previous therapy for their non-small lung cancer were eligible for the study. Of the 200 patients randomized, a total of 193 patients, 99 on the neutron arm and 94 on the photon arm, were eligible for analysis. The two groups were balanced with regards to prognostic factors. At the time of this analysis, the median at-risk follow-up was 33 months, with a minimum follow-up of 16 months. No difference in overall survival was observed: however, there was a statistically significant improvement in survival for patients with squamous cell histology (p=0.02), and a trend toward improved survival for those with favorable prognostic factors (i.e., patients who were not T4, N3, and had no pleural effusion or weight loss > 5% from baseline) (p = 0.15), favoring the neutron-treated group. With the exception of skin and subcutaneous changes, acute and late toxicity was similar in both arms. In selected patients with inoperable regional non-small cell lung cancer (e.g., squamous cell histology, favorable prognostic factors), fast neutron irradiation provides a therapeutic benefit over conventional photon radiotherapy. 20 refs., 4 figs., 3 tabs.

• Sponsoring Organization: USDOE
• OSTI ID: 54864
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 3 Vol. 27; ISSN 0360-3016; ISSN IOBPD3
• Country of Publication: United States
• Language: English

Related Subjects

55 BIOLOGY AND MEDICINE
BASIC STUDIES
56 BIOLOGY AND MEDICINE
APPLIED STUDIES
BIOLOGICAL RADIATION EFFECTS
HUMAN POPULATIONS
NEOPLASMS
NEUTRON THERAPY
PHOTON TRANSMISSION SCANNING
RADIOTHERAPY
RESPIRATORY SYSTEM DISEASES