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Definitive Proton Beam Therapy for Second Primary Non-small Cell Lung Cancer After Pneumonectomy
Masatoshi Nakamura1, Kayoko Ohnishi1,2, Toshiyuki Okumura1,3
1Department of Radiation Oncology, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
International Journal of Particle Therapy
|October 6, 2025
Summary
Proton beam therapy (PBT) shows promise for treating secondary lung cancers in patients who have undergone pneumonectomy. This study found PBT to be effective with manageable side effects in a small group of patients.
Area of Science:
- Oncology
- Radiation Oncology
- Pulmonology
Background:
- Non-small cell lung cancer (NSCLC) management after pneumonectomy presents unique challenges.
- Second primary lung cancers require tailored treatment strategies.
- Proton beam therapy (PBT) offers precise radiation delivery, potentially benefiting patients with compromised lung function.
Purpose of the Study:
- To evaluate the efficacy and safety of definitive PBT for second primary NSCLC in patients who previously underwent pneumonectomy.
- To assess treatment outcomes, including survival and recurrence patterns.
- To analyze adverse events associated with PBT in this specific patient cohort.
Main Methods:
- Retrospective analysis of 4 patients with second primary NSCLC treated with PBT after pneumonectomy (2006-2019).
- Patients had squamous cell carcinoma and were inoperable due to poor respiratory function.
- Median follow-up and treatment characteristics were recorded.
Main Results:
- Median survival time was 46.6 months.
- Relapse occurred in all patients, with patterns including local recurrence (inside/outside irradiated field) and regional recurrence.
- Grade 2 pneumonitis was observed in 2 patients, managed without steroids; no severe (grade ≥3) pneumonitis occurred.
Conclusions:
- Definitive PBT is a viable and safe treatment option for new lung lesions in the remaining lung after pneumonectomy.
- The treatment demonstrated success with no serious adverse events in this small case series.
- Further research with larger cohorts is warranted to confirm these findings.
