Advanced Nsclc
Conditions
Brief summary
Lung cancer is a malignant tumor that causes the highest morbidity and mortality, and the main pathological type is non-small cell lung cancer (NSCLC). Most of them present with advanced stage at diagnosis. Radiotherapy is an important treatment strategy for advanced non-small cell lung cancer. However patients have different responses to radiotherapy due to individual differences, thus there is still lacking of sensitive markers to predict treatment response at present. Using bioinformatics to process the data and small sample clinical trial, our previous study found 5 plasma miRNAs were related to radiosensitivity. The design is controlled clinical trial. According to the size of lung lesions, the investigators divided the patients into hyperfractionated radiotherapy group（50Gy/11F/2W) with lesion ≤5cm in diameter and conventional fractionated radiotherapy group（60Gy/30F/6W）with lesion \>5cm in diameter.
Interventions
RADIATIONradiotherapy
The patient in supine position with hands catch the plate column by crossing the head, and body fixed by vacuum mould. An enhanced 4DCT scan is conducted with a layer thickness and a distance each of 5 mm. the imaging information is input into the Eclipse program system,the gross tumor volume of the primary tumor (GTVt) and pathological lymph nodes (GTVn) are delineated,GTV is expanded in all 3D direction to create PGTV by 5mm margin for squamous cell carcinoma, or an 8mm margin for adenocarcinoma.Radiaion therapy is delivered by 5F-IMRT.For conventional fractionated radiotherapy,the prescribed dose covering 95% of PGTV is 60Gy/30F/6W.For hyperfractionated radiotherapy,the prescribed dose covering 95% of PGTV is 50Gy/11F/2W.lung V20 \<25%, lung V30 \<18%, spinal cord \<36 Gy.
Sponsors
Xinqiao Hospital of Chongqing
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
1. Pathological histology and/or cytology confirmed NSCLC; 2. Based on AJCC Cancer Staging, IIIA, IIIB, IV lung cancer patients with NSCLC; 3. PS 0-2; 4. Expected survival \> 3 months; 5. Age 18\ 75 years old; 6. The function of lung, liver, kidney, bone marrow was normal; 7. The patients had not received radiotherapy for previous primary tumor and metastases; 8. At least accept 2-4 cycles of chemotherapy,not disease progression after chemotherapy,start radiotherapy in two weeks after the last cycle of chemotherapy; 9. Wild-type EGFR; 10. Sensitive mutant EGFR, but refused to targeted therapy; 11. In line with the indications of radiotherapy and accept it; 12. Voluntarily enrolled to participate in,better compliance, cooperate with experimental observations, and sign informed consent.
Exclusion criteria
1. Vital organs (e.g., heart, liver, kidney) have serious dysfunction; 2. Patients with other malignancies; 3. Patients with a history of autoimmune disease; 4. The patients are pregnant and lactating (Women of childbearing age need to check the pregnancy test); 5. In the activity of acute or chronic infectious diseases; 6. Patients with a clear history of drug allergy or allergic genus; 7. Patients with participating in other clinical trials at the same time; 8. Other cases that researchers believe that patients should not participate in the present trial.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Objective Response Rate（ORR） | up to two and a half years |
Secondary
| Measure | Time frame |
|---|---|
| Correlation between the expression level of miRNAs and the ORR. | up to two and a half years |
| Progression free survival（PFS） | up to two and a half years |
| side effects of radiation | up to two and a half years |
Countries
China
Outcome results
None listed