Historical T 1-2 peripheral lung cancer Cancer Historical T 1-2 peripheral lung cancer
Conditions
Interventions
Comparing the current, traditional planning method of optimising Lung Stereotactic-Ablative Radiotherapy (SABR) cancer, against an advanced optimisation method, Multi-Criteria Optimisation (MCO). Lung
Sponsors
NHS Tayside
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Historical patients (2015-2018) 2. T 1-2 peripheral lung cancer patient 3. Within geographical catchment area of the Radiotherapy Department 4. Aged over 18 years old 5. Already been previously planned, and are deemed suitable for SABR 6. Pathologically confirmed non-small cell lung cancer (NSCLC). If biopsy deemed unsafe, enhancing lesion on FDG PET with radiological characteristics in keeping with NSCLC 7. Patient deemed by MDM as medically unfit for surgery or has declined surgery (WHO PS 0-2) 8. Lesion =5 cm with no pathologically enlarged lymph nodes or distant metastases. Mediastinal staging with EBUS should be considered in patients with enlarged or PET equivocal tumours. 9. Lesion >2 cm from main bronchi, oesophagus and the major blood vessels 10. No absolute constraints for FEV1 or DLCO, but patients with interstitial lung disease or established lung fibrosis should be treated with caution
Exclusion criteria
Exclusion criteria: 1. Not deemed suitable for SABR 2. Previously planned 3. NSCLC patients with T2 or T3 primary tumours >5 cm. 4. Metastatic (including to lymph nodes) lung cancer 5. Any tumour that is not clinically definable on the treatment planning CT scan e.g. surrounded by consolidation or atelectasis 6. Tumours within 2 cm radius of main airways and proximal bronchial tree 7. Previous radiotherapy within the planned treatment volume 8. Presence of pulmonary fibrosis (unless the increased risk of SABR has been fully considered and the patient has been appropriately consented) 9. Chemotherapy administered within 6 weeks prior to study entry or planned for <6 weeks following SABR 10. Pregnant or lactating females If tumour has respiratory motion =1 cm, only proceed with treatment if target delineation is reliable and suggested normal tissue and tumour planning constraints can be achieved.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Amount of radiation dose (Gy) that the chest wall receives in the radiotherapy plans. The baseline, or comparison measurement, will be the traditionally optimised radiotherapy plan. The traditionally optimised plan will be planned first and then the MCO optimised plan will be computed on the same day. A delayed timepoint is not required as the same planning CT scan and data will be used for each patient case, it is just the method of optimising the plan that differs. | — |
Secondary
| Measure | Time frame |
|---|---|
| The following will be assessed through recording the time taken for each plan, along with observations regarding the ease and/or any difficulties encountered with MCO optimisation, whilst planning each case: 1. Reducing the need for manual in-put of the planner 2. Improve the speed with which plans are produced 3. Aid in the training of staff in Lung Cancer Stereotactic Ablative Radiotherapy (SABR) planning | — |
Countries
United Kingdom
Contacts
Public ContactLaura Ferguson
Outcome results
None listed