Executive summary

Published in the Red Journal, this is a brief report detailing a novel prospective feasibility and phase1/2 dose-scalation study of PBT as part of trimodality treatment for locally advanced non-small cell lung cancer (LA-NSCLC). Based on the 19 patients analyzed in this study, overall pathologic complete response (pCR) rate was 5 of 19 (26%), nodal pCR rate was 8 of 18 (44%), and 5-year OS was 40%. Only 2 patients (10%) experienced grade 3 RT-related acute toxicities, both occurring postoperatively, and no patient experienced an acute grade 4 to 5 non hematologic toxicity. Notably, nodal pCR occurred in 4 of 5 patients (80%) who received 59.4Gy. These nodal pCR figures compare favorably to those seen with full-dose photon therapy. The authors concluded that with this encouraging result, future studies could test neoadjuvant PBT alongside immunotherapy, plus or minus chemotherapy, to further improve outcomes while minimizing cardiopulmonary RT dose and toxicity. 

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