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NCT Number: NCT01207063

Adaptive Radiotherapy in Non-small Cell Lung Cancer (NSCLC)

The investigators group uses an individualised radiation dose approach in which the dose is escalated up to pre-defined tissue constraints (see below). The target dose to the tumor is 69Gy. However, this dose cannot be reached in approximately 30% of the patients, even with an IMRT (Intensity Modulated Radiotherapy) technique, because the MLD (Mean Lung Dose) constraint of 20Gy is reached at a TTD (Total Treatment Dose) below 69Gy. In this study, the investigators will adapt the treatment by performing a new (PET)-CT at day 12 during radiotherapy and in case of a decreased Planning Target Volume (PTV), the dose mey be increased.

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Key information

Conditions

Non-small Cell Lung Cancer Bronchial Neoplasms Carcinoma, Bronchogenic Carcinoma, Non-Small-Cell Lung Lung Diseases Lung Neoplasms Neoplasms Neoplasms by Site Respiratory Tract Diseases Respiratory Tract Neoplasms Thoracic Neoplasms

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2

Primary location

MAASTRO clinic

Maastricht, Limburg, 6229 ET, Netherlands

About this study

Eligible patients will receive concurrent chemo-radiotherapy to the primary tumor and the initially involved mediastinal lymph nodes to an MLD (Mean Lung Dose) of 20 +/- 1Gy, irrespective of lung function.

Other dose constraints: spinal cord max: 54Gy, brachial plexus (Dmax):66Gy.

In concurrent with chemotherapy, radiotherapy will be delivered as follows:

  • First three weeks /30 fractions:twice-daily fractions of 1.5Gy, with 8h to 10h as interfraction interval, 5 days per week. Total dose: 45Gy/30 fractions.
  • Thereafter: once-daily fractions of 2.0Gy, 5 days per week until the target dose has been reached.

In sequential or radiotherapy alone schedules, twice-daily 1.8Gy with an interfraction interval of at least 8h will be delivered.

The radiation doses will be specified according to ICRU 50. Lung density corrections will be applied, as well as all standard QA procedures. Technical requirements are the same as in standard practice at MAASTRO clinic.

Chemotherapy schedules allowed:

  • 1-2 cycles induction chemotherapy: any third generation schedule is allowed. The type will be registered.
  • Concurrent part: (day 1=first day of radiotherapy)
  • cisplatin-vinorelbine
  • cisplatin-docetaxel
  • cisplatin-etoposide
  • cisplatin-pemetrexed in non-squamous histologies

Q3 week; 3 cycles

When the calculated creatinin clearance is less than 60 ml/min, cisplatin may be substituted for carboplatin.

In case the TTD(Total Treatment Dose)=69Gy cannot be reached because of a limiting MLD, a FDG-PET-CT will be performed at day 12 during radiotherapy. GTV's (Gross Tmor Volume), CTV's (Clinical Target Volume) and PTV's (Planning Target Volume) will be delineated and a new plan calculated. The endpoint will be the proportion of patients that will receive 69Gy.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Histological or cytological proven NSCLC
  • UICC stage I-III, or solitary metastases (<6), which are amendable for radical local treatment
  • Performance status 0-2
  • IMRT technique

Exclusion criteria

  • Not NSCLC of mixed NSCLC and other histologies (e.g. small cell carcinoma)
  • Stage IV, except for solitary (<6) metastases
  • Performance status 3 or more

Treatment and study plan

Radiotherapy and concurrent chemo-therapy

Other

Radiotherapy and concurrent chemo-therapy

Primary outcomes

  1. Proportion of patients able to receive 69Gy as TTD

    Time frame: 3 months

Secondary outcomes

  1. Overall survival

    Time frame: 3 months

  2. Progression free survival

    Time frame: 3 months

  3. Dyspnea (CTCAE 4.0)

    Time frame: 3 months

  4. Dysphagia (CTCAE 4.0)

    Time frame: 3 months

  5. Patterns of recurrence

    Time frame: 3 months

Sponsors and collaborators

Lead sponsor

Maastricht Radiation Oncology

Other

Registry information

Official study title

Adaptive Radiotherapy for Stage II-III Non-small Cell Lung Cancer

Important dates

Study start
2011
Primary completion
2018
Study completion
2018
First posted
Sep 22, 2010
Registry last updated
Aug 17, 2018

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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