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Avoiding Cardiac Toxicity in Lung Cancer Patients Treated With Curative-intent Radiotherapy

Not Applicable
Conditions
Lung Cancer
Interventions
Diagnostic Test: Blood tests & cardiac imaging
Registration Number
NCT03645317
Lead Sponsor
Prof Corinne Faivre-Finn
Brief Summary

Radiotherapy plays a major role in the treatment of lung cancer and recent advances in radiotherapy have led to better cure rates. However, the radiotherapy dose needed to destroy the cancer cells can unfortunately also damage the surrounding organs, such as the heart. The precise mechanism of damage and which areas of the heart are more sensitive to radiation is not currently known. This project uses the analysis of large amounts of existing radiotherapy treatment data to determine this. Establishing detailed radiotherapy dose limits for the heart and the heart's sub-structures will lead to the delivery of heart-sparing radiotherapy, where possible, in lung cancer patients treated in Yorkshire and Greater Manchester. The investigators estimate that this should lead to an improvement in one-year survival of approximately 10%.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
200
Inclusion Criteria
  • Histological or clinical diagnosis of lung cancer (Stage I-III non-small cell and small cell lung cancer) suitable for curative-intent radiotherapy
  • Patients suitable for curative-intent radiotherapy (minimum 20 fractions for conventional fractionation and 3-8 fractions for SABR)
  • Life expectancy > 4 months
  • Age ≥ 18 years
  • Patient has read and understood the participant information sheet and given informed consent

Exclusion criteria:

  • No histological or clinical diagnosis of lung cancer (Stage I-III non-small cell and small cell lung cancer) and not suitable for curative-intent radiotherapy
  • Patients not suitable for curative-intent radiotherapy (minimum 20 fractions for conventional fractionation and 3-8 fractions for SABR)
  • Life expectancy < 4 months
  • Age < 18 years
  • Patient has not read and understood the participant information sheet and has not given informed consent
Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Single armBlood tests & cardiac imagingBlood samples (FBC, lipids, cholesterol, troponin, CRP, BNP) Cardiac imaging (cardiac CT, cardiac ultrasound, 12-lead ECG)
Primary Outcome Measures
NameTimeMethod
The effect of radiation dose to the heart assessed using blood test (lipids & cholesterol - LDL & HDL levels)4 months (duration of each participant on study)

The effect of radiation dose to the heart assessed using lipid \& cholesterol (LDL \& HDL) measurements at the following time points (before radiotherapy, within 7 days post-radiotherapy and at 4 months post-radiotherapy)

The effect of radiation dose to the heart assessed using blood test (brain natriuretic peptide)4 months (duration of each participant on study)

The effect of radiation dose to the heart assessed using brain natriuretic peptide measurement at the following time points (before radiotherapy, within 7 days post-radiotherapy and at 4 months post-radiotherapy)

The effect of radiation dose to the heart assessed using cardiac imaging (cardiac CT)4 months (duration of each participant on study)

The effect of radiation dose to the heart assessed using cardiac CT scans at the following time points (before radiotherapy and at 4 months after radiotherapy). The following components of the cardiac CT scan measured during the study: coronary calcium score (Agaston/Volume) - CAC-RDS 0, CAC-RDS 1, CAC-RDS 2, CAC-RDS 3, CAC-RADS classification.

The effect of radiation dose to the heart assessed using blood test (troponin)4 months (duration of each participant on study)

The effect of radiation dose to the heart assessed using troponin measurement at the following time points (before radiotherapy, within 7 days post-radiotherapy and at 4 months post-radiotherapy)

The effect of radiation dose to the heart assessed using blood test (C-reactive protein)4 months (duration of each participant on study)

The effect of radiation dose to the heart assessed using C-reactive protein measurement at the following time points (before radiotherapy, within 7 days post-radiotherapy and at 4 months post-radiotherapy)

The effect of radiation dose to the heart assessed using cardiac imaging (12-lead ECG)4 months (duration of each participant on study)

The effect of radiation dose to the heart assessed using 12-lead ECG at the following time points (before radiotherapy and at 4 months after radiotherapy). The following components of the ECG measured during the study: heart rate, rhythm, P wave, QRS complex, QT interval, ST segment \& PR interval.

The effect of radiation dose to the heart assessed using blood test (full blood count)4 months (duration of each participant on study)

The effect of radiation dose to the heart assessed using full blood count measurement at the following time points (before radiotherapy, within 7 days post-radiotherapy and at 4 months post-radiotherapy)

The effect of radiation dose to the heart assessed using cardiac imaging (cardiac ultrasound)4 months (duration of each participant on study)

The effect of radiation dose to the heart assessed using cardiac ultrasound scans at the following time points (before radiotherapy and at 4 months after radiotherapy). The following components of the cardiac ultrasound measured during the study: parasternal long axis, parasternal short axis, apical 2/4/5 chambers, apical long axis, subcostal and parasternal notch.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (2)

Leeds Teaching Hospitals NHS Trust

🇬🇧

Leeds, United Kingdom

The Christie NHS Foundation Trust

🇬🇧

Manchester, United Kingdom

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