Multi-Institutional Prospective Study of Reirradiation with Proton Beam Radiotherapy for Locoregionally Recurrent Non–Small Cell Lung Cancer Hann-Hsiang.

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Multi-Institutional Prospective Study of Reirradiation with Proton Beam Radiotherapy for Locoregionally Recurrent Non–Small Cell Lung Cancer Hann-Hsiang Chao, MD, PhD, Abigail T. Berman, MD, MSCE, Charles B. Simone, MD, Christine Ciunci, MD, Peter Gabriel, MD, Haibo Lin, PhD, Stefan Both, PhD, Corey Langer, MD, Kristi Lelionis, MS, Ramesh Rengan, MD, PhD, Stephen M. Hahn, MD, Kiran Prabhu, MD, Marcio Fagundes, MD, William Hartsell, MD, Rosemarie Mick, MS, John P. Plastaras, MD, PhD Journal of Thoracic Oncology Volume 12, Issue 2, Pages 281-292 (February 2017) DOI: 10.1016/j.jtho.2016.10.018 Copyright © 2016 International Association for the Study of Lung Cancer Terms and Conditions

Figure 1 Representative proton reirradiation plan. A representative reirradiation treatment plan shown in the Eclipse treatment planning system. The patient was treated using posterior and left posterior oblique beam angles. A dose-volume histogram is shown (top right) with dose statistics highlighted in the bottom table for the structures of the total lung, heart, esophagus, and spinal cord. The dose cloud minimum threshold is set at 500 cGy. iCTV, internal clinical target volume; PTV, planning target volume; GTV, gross tumor volume. Journal of Thoracic Oncology 2017 12, 281-292DOI: (10.1016/j.jtho.2016.10.018) Copyright © 2016 International Association for the Study of Lung Cancer Terms and Conditions

Figure 2 Actuarial time to grade 3 or higher toxicity. Time to and rate of development of any grade 3 or higher toxicity event for all patients in study cohort. Journal of Thoracic Oncology 2017 12, 281-292DOI: (10.1016/j.jtho.2016.10.018) Copyright © 2016 International Association for the Study of Lung Cancer Terms and Conditions

Figure 3 Survival outcomes and association with clinical and dosimetric factors. (A) Overall survival (OS) for all patients in study cohort. (B) Progression-free survival (PFS) for all patients in study cohort. (C) One-year OS for patients stratified by amount of central region volume overlap. (D) One-year OS for patients stratified by status of concurrent chemotherapy. (E) One- year OS for patients stratified by mean heart dose. (F) One-year OS for patients stratified by mean esophagus dose. Journal of Thoracic Oncology 2017 12, 281-292DOI: (10.1016/j.jtho.2016.10.018) Copyright © 2016 International Association for the Study of Lung Cancer Terms and Conditions