With concurrent chemotherapy, proton-beam therapy is safe and may be effective for patients with limited-stage small-cell lung cancer (SCLC), according to a study published in Cancer.1

Radiotherapy is critical for effective lung cancer treatment, though when used with chemotherapy serious adverse events can occur. While some data show that proton-beam therapy reduces toxicity for patients with non–small cell lung cancer, there are limited data for patients with SCLC.

For this prospective study, researchers enrolled 30 patients with limited-stage SCLC to receive proton-beam therapy with concurrent cisplatin plus etoposide or carboplatin plus etoposide.

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The median dose of 63.9 cobalt gray equivalents were delivered once daily to 18 patients and twice daily to 12 patients; the total number of fractions ranged from 33 to 37.

The dosimetry of proton-beam therapy regimens was compared with that of generated intensity-modulated radiotherapy (IMRT) clinical backup plans.

Median follow-up was 14 months. The 1- and 2-year local control rates with proton-beam therapy were 85% and 69%, respectively. Median overall survival was 28.2 months; the 1- and 2-year overall survival rates were 72% and 58%, respectively.

Proton-beam therapy significantly improved dosimetry over IMRT of at least 5 Gy for the heart and spinal cord, “but not in the esophagus mean dose or the lung volume receiving at least 20 Gy.”

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One patient who received proton-beam in twice daily–fractions had grade 4 esophagitis. There were 3 other cases of grade 3 adverse events among all patients receiving proton therapy.

The authors concluded that “[proton-beam therapy] as part of a combined modality therapy for [limited stage]-SCLC is feasible and safe, with preliminary evidence showing encouraging efficacy in comparison with photon radiation.”


  1. Rwigema JC, Verma V, Lin L, et al. Prospective study of proton-beam radiation therapy for limited-stage small cell lung cancer. Cancer. 2017 Jul 5. doi: 10.1002/cncr.30870 [Epub ahead of print]