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EDITORIAL Role of Carbon Ion Therapy for Stage I NSCLC Using a Regimen of Four Fractions over Week Robert Orecchia, MD, and Piero Fossati, MS, MD tage I NSCLC can be cured with radical surgery; the reported 5-years overall survival Srate ranged from 55% up more than 70%. Even with modern techniques there is a low, but nonzero, in-hospital death rate of 0.8%. Lobectomy, performed by thoracothomy or video-assisted thoracoscopic approach is the surgical procedure of choice, being more limited resection less effective in local control rates. Loss of pulmonary parenchyma has a negative impact on respiratory function and can reflect in a decreased quality of life. In the past, patients unable to withstand lobectomy and/or the related surgical stress have been traditionally treated with standard radiotherapy (RT) at doses of about 60 Gray. The outcomes were clearly inferior to those of surgery with reported 5-years overall survival of 23%. Modern high precision photons radiotherapy (Image-Guided RT and others) can be substantially more effective. For example, stereotactic technique (SRT) allow to selectively deliver higher doses to the detectable tumor (plus a margin). Hypofractionated schedules with only few (typically less than 5) treatment sessions are given. A large retrospective analysis
Journal of Thoracic Oncology – Wolters Kluwer Health
Published: Oct 1, 2007
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