Non Small Cell Lung Cancer
Conditions
Brief summary
This study aims to use a type of radiation (adaptive radiotherapy) to deliver curative-intent treatment to patients with non-small cell lung cancer, whose tumors would otherwise be too large for standard curative treatment. The study will use adaptive radiotherapy to achieve these goals. Adaptive radiotherapy is a process whereby treatment plans are modified during the course of treatment due to patient and tumor variations (ie. weight loss or tumor shrinkage). This may allow for dose escalation, while limiting the side effects.
Interventions
RADIATIONAdaptive radiotherapy
Sponsors
London Regional Cancer Program, Canada
London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age 18 or older * Willing to provide informed consent * ECOG performance status 0-2 * Histologically confirmed non-small cell lung carcinoma * Locally advanced stage IIIA or IIIB lung carcinoma according to AJCC 7th edition * Expected lung V20 of 35-60%, as determined at the time of 4D-CT simulation * Assessment by medical oncologist and radiation oncologist, with adequate hepatic and renal function for administration of cisplatin-based doublet chemotherapy, at the discretion of the medical oncologist
Exclusion criteria
* Serious medical comorbidities or other contraindications to radiotherapy or chemotherapy * Prior history of lung cancer within 5 years * Prior thoracic radiation at any time * Metastatic disease * in some select cases, patients with a solitary metastasis (i.e. brain metastasis) may receive radical chemoradiotherapy after resection/ablation of their metastatic lesion, as standard practice. In such cases, the patient may be enrolled onto this study at the discretion of the local principle investigator once the metastasis has been treated. * inability to attend full course of radiotherapy of follow-up visits * Pregnant or lactating women
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Tumor reduction | 2.5 years (end of treatment) |
Secondary
| Measure | Time frame |
|---|---|
| Overall survival | 2.5 years |
| Rate of tumor shrinkage | 2.5 years (end of treatment) |
| Local control | 2.5 years (end of treatment) |
| Delivered doses | 2.5 years (end of treatment) |
| Radiation pneumonitis rates | 6 months, 12 months, 18 months, 24 months, 30 months (semi-annually) |
| Change in lung dose | 2.5 years (end of treatment) |
Countries
Canada
Outcome results
None listed