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Cisplatin, Etoposide, and Radiation Therapy in Treating Patients With Limited-Stage Small Cell Lung Cancer

Phase 2
Completed
Conditions
Lung Cancer
Interventions
Radiation: Radiation therapy
Registration Number
NCT00066222
Lead Sponsor
Radiation Therapy Oncology Group
Brief Summary

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells. Combining more than one chemotherapy drug with radiation therapy may kill more tumor cells.

PURPOSE: This phase II trial is studying how well giving cisplatin and etoposide together with radiation therapy works in treating patients with limited-stage small cell lung cancer.

Detailed Description

OBJECTIVES:

* Determine the response rate of patients with limited stage small cell lung cancer treated with cisplatin and etoposide combined with accelerated high-dose thoracic radiotherapy.

* Determine the progression-free and overall survival in patients treated with this regimen.

* Determine the qualitative and quantitative toxicity and reversibility of toxicity of this regimen in these patients.

OUTLINE: Patients undergo radiotherapy once daily 5 days a week for approximately 3 weeks and then twice daily 5 days a week for approximately 2 weeks (a total of 9 treatment days during the final 2-week treatment period). Beginning on the first day of radiotherapy, patients receive cisplatin IV over 2 hours and etoposide IV over 1 hour on day 1 and oral etoposide once daily on days 2 and 3. Chemotherapy repeats every 3 weeks for up to 4 courses in the absence of disease progression or unacceptable toxicity.

Patients are followed every 3 months for 1 year, every 6 months for 2 years, and then annually thereafter.

PROJECTED ACCRUAL: A total of 71 patients will be accrued for this study within 18 months.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
72
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Radiation Therapy + ChemotherapyRadiation therapyAccelerated high dose thoracic radiation therapy (RT) with concurrent cisplatin/etoposide chemotherapy, followed by 2 cycles of adjuvant cisplatin/etoposide chemotherapy
Radiation Therapy + ChemotherapyEtoposideAccelerated high dose thoracic radiation therapy (RT) with concurrent cisplatin/etoposide chemotherapy, followed by 2 cycles of adjuvant cisplatin/etoposide chemotherapy
Radiation Therapy + ChemotherapyCisplatinAccelerated high dose thoracic radiation therapy (RT) with concurrent cisplatin/etoposide chemotherapy, followed by 2 cycles of adjuvant cisplatin/etoposide chemotherapy
Primary Outcome Measures
NameTimeMethod
Overall Survival at 2 YearsFrom registration to 2 years

Survival time is defined as time from study registration to the date of death from any cause and survival rates are estimated by the Kaplan-Meier method. Patients last known to be alive are censored at the date of last contact.

Secondary Outcome Measures
NameTimeMethod
Overall Survival (OS) and Progression-free Survival (PFS) at 1 YearFrom registration to one year.

An event for overall survival is death due to any cause. Overall survival time is defined as time from study registration to the date of death from any cause. An event for progression-free survival is the first of the following: local progression, regional progression, distant metastases, or death due to any cause. Progression-free survival time is defined as time from study registration to the date of first failure. For both outcome measures, patients last known to be alive without failure are censored at the date of last contact. Survival rates are estimated by the Kaplan-Meier method.

Tumor ResponseFrom the start of treatment to 2 months following the completion of chemotherapy

Response will be recorded as the best response observed two months after the completion of chemoradiation therapy. Tumor response as defined by Response Evaluation Criteria in Solid Tumors (RECIST). Complete Response (CR): Disappearance of all target lesions as measured by MRI, CT, or physical examination (this is the order of preference for measurement). Partial Response (PR): \>= 30% decrease in the sum of the longest diameter (LD) of target lesions (order of preference for measurement is MRI, CT, physical examination). Progressive Disease (PD): \>= 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions (order of preference for measurement is MRI, CT, physical examination). Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the treatment started.

Median Overall Survival Time and Progression-free Survival TimeFrom registration to 2 years

An event for overall survival is death due to any cause. Overall survival time is defined as time from study registration to the date of death from any cause. An event for progression-free survival is the first of the following: local progression, regional progression, distant metastases, or death due to any cause. Progression-free survival time is defined as time from study registration to the date of first failure. For both outcome measures, patients last known to be alive without failure are censored at the date of last contact. Survival rates are estimated by the Kaplan-Meier method.

Number of Patients With Acute Treatment-related Grade 3 or 4 EsophagitisFrom start of radiation therapy until 90 days following the start of radiation therapy

Highest grade treatment-related toxicity per subject was counted. Toxicities were graded using Common Toxicity Criteria (CTC) v 2.0. Grade refers to the severity of the toxicity. Both criteria assign Grades 1 through 5 with unique clinical descriptions of severity for a given toxicity based on this general guideline: Grade 1= Mild, Grade 2= Moderate, Grade 3= Severe, Grade 4= Life-threatening or disabling, Grade 5= Death related to toxicity.

Frequency of Treatment-related Fatalities at 2 YearsFrom the start of treatment to 2 years

A treatment-related fatality was any death judged to be related to protocol treatment.

Trial Locations

Locations (104)

Comprehensive Cancer Center at University of Alabama at Birmingham

🇺🇸

Birmingham, Alabama, United States

Eden Medical Center

🇺🇸

Castro Valley, California, United States

Saint Rose Hospital

🇺🇸

Hayward, California, United States

Highland General Hospital at St. George's University School of Medicine

🇺🇸

Oakland, California, United States

Alta Bates Summit Medical Center - Summit Campus

🇺🇸

Oakland, California, United States

CCOP - Bay Area Tumor Institute

🇺🇸

Oakland, California, United States

Valley Care Medical Center

🇺🇸

Pleasanton, California, United States

Robert and Beverly Lewis Family Cancer Care Center at Pomona Valley Hospital Medical Center

🇺🇸

Pomona, California, United States

J.C. Robinson, M.D. Regional Cancer Center

🇺🇸

San Pablo, California, United States

Curtis & Elizabeth Anderson Cancer Institute at Memorial Health University Medical Center

🇺🇸

Savannah, Georgia, United States

Scroll for more (94 remaining)
Comprehensive Cancer Center at University of Alabama at Birmingham
🇺🇸Birmingham, Alabama, United States

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