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dc.contributor.authorJongen, Aurélien
dc.contributor.authorCharlier, Florian
dc.contributor.authorBaker, Kelsey
dc.contributor.authorChang, John
dc.contributor.authorHartsell, William
dc.contributor.authorLaramore, George
dc.contributor.authorMohindra, Pranshu
dc.contributor.authorMoretti, Luigi
dc.contributor.authorRedman, Mary
dc.contributor.authorRosen, Lane
dc.contributor.authorTsai, Henry
dc.contributor.authorVan Gestel, Dirk
dc.contributor.authorVargas, Carlos
dc.contributor.authorRengan, Ramesh
dc.date.accessioned2022-01-20T12:54:48Z
dc.date.available2022-01-20T12:54:48Z
dc.date.issued2022-01-01
dc.identifier.urihttp://hdl.handle.net/10713/17694
dc.description.abstractPurpose: For most disease sites, level 1 evidence is lacking for proton beam therapy (PBT). By identifying target populations that would benefit most from PBT, prospective registries could overcome many of the challenges in clinical trial enrollment. Herein, we report clinical outcomes of patients treated with PBT for locally advanced non-small cell lung cancer (LA-NSCLC). Methods and Materials: Data were obtained from the multi-institutional prospective database of the Proton Collaborative Group (PCG). Inclusion criteria of our study were stage III de novo or recurrent LA-NSCLC, use of PBT, and availability of follow-up data. Overall survival (OS) time was calculated from the start of treatment until death or last follow-up. Kaplan-Meier curves were generated for groups of interest and compared with log-rank tests. Cox regression modeling was used to evaluate the multivariate association between selected covariates and OS. Results: A total of 195 patients were included in the analysis. PBT was given with a median equivalent dose in 2 Gy fractions (EQD2) of 63.8 Gy (relative biological effectiveness). Pencil beam scanning was used in 20% of treatments. Treatment-related grade 3 adverse events were rare: 1 pneumonitis, 2 dermatitis, and 3 esophagitis. No grade 4 events were reported. Two cardiac-related grade 5 events occurred in patients with multiple risk factors. The median follow-up time for living patients was 37.1 months and the median OS was 19.0 months. On multivariate analysis, good performance status (hazard ratio, 0.27; [95% confidence interval, 0.15-0.46]; P < .0001), pencil beam scanning use (0.55; [0.31-0.97]; P = .04), and increased EQD2 (0.80; [0.71-0.90] - per 10 Gy increase; P = .0002) were associated with decreased mortality. Conclusions: PBT appears to yield low rates of adverse events with an OS similar to other retrospective studies on PBT for LA-NSCLC. PBS use and increased EQD2 can potentially improve OS. © 2021 The Authorsen_US
dc.description.urihttps://doi.org/10.1016/j.adro.2021.100767en_US
dc.publisherElsevieren_US
dc.relation.ispartofAdvances in Radiation Oncologyen_US
dc.titleClinical Outcomes After Proton Beam Therapy for Locally Advanced Non-Small Cell Lung Cancer: Analysis of a Multi-institutional Prospective Registryen_US
dc.typeArticleen_US
dc.identifier.doi10.1016/j.adro.2021.100767
dc.source.journaltitleAdvances in Radiation Oncology
dc.source.volume7
dc.source.issue1


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