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Review | Open Access

Carbon ion radiotherapy in the management of non-small cell lung cancer

Danushka Seneviratne1, Hitoshi Ishikawa2, Jingfang Mao3, Jingjing M. Dougherty1, Aaron Bush1, Mathew Thomas4, Rami Manochakian5, Yanyan Lou5, Dawn Owen6, Terence T. Sio7, Jessica Kirwan8, Stephen J. Ko1, Bradford S. Hoppe1 ( )
Department of Radiation Oncology, Mayo Clinic Florida, Jacksonville, Florida, USA
QST Hospital National Institutes for Quantum Science and Technology, Chiba, Japan
Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Shanghai Cancer Center, Shanghai, China
Department of Cardiothoracic Surgery, Mayo Clinic Florida, Jacksonville, Florida, USA
Department of Medicine, Division of Hematology/Oncology, Mayo Clinic Florida, Jacksonville, Florida, USA
Department of Radiation Oncology, Mayo Clinic Minnesota, Rochester, Minnesota, USA
Department of Radiation Oncology, Mayo Clinic Arizona, Phoenix, Arizona, USA
Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida, USA
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Abstract

Despite advancements in local-regional and systemic therapies, non-small cell cancer (NSCLC) remains a leading cause of death worldwide. Among those treated with standard-of-care modalities, 30–60% experience disease recurrence. Carbon ion radiotherapy (CIRT) is a form of densely ionizing radiotherapy with unique physical and biological advantages over traditional photon and proton modalities. CIRT is expected to have a superior biological impact on tumors, and is believed to be less impacted by the presence of tumor hypoxia or cell cycle state. It also shows highly conformal physical dose deposition due to reduced lateral scattering of the particles, limiting the radiation dose delivered to adjacent organs at risk. To implement CIRT as a viable option in the treatment of NSCLC, technical aspects of treatment delivery –including appropriate beam arrangements, dose calculation algorithms, radiobiological models, and methods of motion management –must be thoroughly investigated. Furthermore, randomized clinical trials comparing CIRT versus traditional radiation modalities must be performed to show the benefits and risks associated with this novel treatment modality. This review discusses the rationale for utilizing CIRT in NSCLC, available clinical data to date, and the potential for future investigations that may pave the path for improving outcomes in those diagnosed with NSCLC.

Keywords

non-small cell lung cancercarbon ionhigh-linear energy transfer

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Precision Radiation Oncology
Volume 6 Issue 1,
March 2022
Pages 69-74
DOI: 10.1002/pro6.1146
Cite this article:
Seneviratne D, Ishikawa H, Mao J, et al. Carbon ion radiotherapy in the management of non-small cell lung cancer. Precision Radiation Oncology, 2022, 6(1): 69-74. https://doi.org/10.1002/pro6.1146

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Received: 16 February 2022
Accepted: 17 February 2022
Published: 22 March 2022
© 2022 The Authors. Precision Radiation Oncology published by John Wiley & Sons Australia, Ltd on behalf of Shandong Cancer Hospital & Institute.

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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