The Use of Proton Therapy in the Treatment of Lung Cancers

Lung cancer is the leading cause of death from cancer in the United States and worldwide. Radiation therapy plays a prominent role in the treatment of patients with nonmetastatic disease. Radiation therapy alone can be curative for patients with stage I non-small cell lung cancer (NSCLC). Radiation therapy is also used as part of multimodality therapy to treat patients with locally advanced NSCLC. Current treatment delivery is often limited by radiation doses received by normal structures and treatment-related toxicities. Proton therapy for lung cancer can reduce the dose received by normal tissues, including the lungs, esophagus, and spinal cord, and may allow for reduced treatment toxicities. Proton therapy may also more safely allow for reirradiation and for radiation therapy to be combined with chemotherapy and surgery. This review discusses the rationales for and current uses of proton therapy to treat lung cancer, and it highlights key studies of proton therapy to treat early-stage and locally advanced NSCLC.