Improved Locoregional Recurrence-Free Survival With Carbon Ion Versus Photon Radiotherapy in Locally Advanced Non-Small Cell Lung Cancer
In brief
Carbon ion radiotherapy more than doubles locoregional recurrence-free survival in stage III lung cancer
In a propensity-matched analysis of 292 patients, carbon ion radiotherapy achieved a median locoregional recurrence-free survival of 57.7 months versus 25 months with conventional photon therapy, and also reduced acute grade 2 or higher toxicities. Overall survival and distant-metastasis outcomes were similar, highlighting a need for prospective trials to confirm the benefit.
- Journal
- Cancer medicine (Q1)
- Published
- 1 September 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Yonglong Liu, Ningyi Ma, Yaqi Li, Jing Mi, Xingwen Fan, Jian Chen, et al.
- PMID
- 42717470
- DOI
- 10.1002/cam4.72229
Why clinicians should know about it
- Picked for Radiation Oncology (paper of the day, 13 September 2026): Carbon ion improves locoregional control vs photons
Abstract
INTRODUCTION: Carbon ion radiotherapy (CIRT) delivers high linear energy transfer radiation with superior dose conformity compared with photon radiotherapy (PRT). However, whether these physical advantages translate into clinical benefit for locally advanced non-small cell lung cancer (LA-NSCLC) in the era of modern systemic therapy remains unclear. METHODS: We performed a retrospective, propensity score-matched cohort study of patients with Stage III LA-NSCLC treated with definitive CIRT or PRT as part of multimodality therapy between January 2016 and December 2023. The primary endpoint was locoregional recurrence-free survival (LRFS). Secondary endpoints included progression-free survival (PFS), overall survival (OS), distant metastasis-free survival (DMFS), and acute grade ≥ 2 radiation-related adverse events (AEs). RESULTS: A total of 292 patients were matched (146 per group). With a median follow-up of 32.5 months, CIRT group demonstrated significantly longer median LRFS (57.7 vs. 25.0 months; HR, 0.59; 95% CI, 0.39-0.88; p = 0.01) and median PFS (17.7 vs. 16.7 months; HR, 0.70; 95% CI, 0.53-0.94; p = 0.02) compared with PRT group, whereas OS and DMFS were similar between groups. CIRT group also had fewer acute grade ≥ 2 radiation-related AEs. CONCLUSIONS: CIRT demonstrated improved locoregional control and fewer acute toxicities compared with PRT in LA-NSCLC in this retrospective matched cohort. Prospective randomized trials are warranted to validate these findings.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.