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Amifostine in Treating Patients With Stage II or Stage III Non-small Cell Lung Cancer

Phase 3
Completed
Conditions
Radiation Toxicity
Oral Complications
Drug/Agent Toxicity by Tissue/Organ
Lung Cancer
Interventions
Biological: filgrastim
Radiation: radiation therapy
Registration Number
NCT00003313
Lead Sponsor
Radiation Therapy Oncology Group
Brief Summary

RATIONALE: Amifostine may be an effective treatment for the toxic side effects caused by radiation therapy and chemotherapy. It is not yet known whether chemotherapy and radiation therapy are more effective with or without amifostine for non-small cell lung cancer.

PURPOSE: Randomized phase III trial to determine the effectiveness of amifostine in treating patients who have stage II or stage III non-small cell lung cancer that cannot be surgically removed and who are undergoing chemotherapy and radiation therapy.

Detailed Description

OBJECTIVES: I. Evaluate whether the addition of the radioprotector amifostine can reduce the incidence and severity of non-hematologic toxicity, specifically esophagitis and pneumonitis, during concurrent hyperfractionated radiotherapy and chemotherapy (with paclitaxel and carboplatin) in patients with stage II, IIIA, or IIIB non-small cell lung cancer. II. Evaluate the differences in quality of life and symptom distress, specifically dysphagia, between patients receiving amifostine and those not receiving amifostine. III. Evaluate the relationship of tobacco use and alcohol use during treatment to appraisals of quality of life and symptom distress, specifically esophagitis, in the two groups. IV. Evaluate the efficacy of induction therapy with paclitaxel and carboplatin followed by concurrent chemotherapy and hyperfractionated radiotherapy in these patients.

OUTLINE: This is an open-label treatment and randomized supportive care study. Patients are stratified according to disease stage (II vs IIIA vs IIIB), Karnofsky performance status (90-100% vs 70-80%), and age (70 and under vs over 70). Patients are randomized to one of two treatment arms. Arm I: Patients receive paclitaxel IV over 3 hours on days 1 and 22 and over 1 hour weekly for 6 weeks beginning on day 43. Patients receive carboplatin IV over 30 minutes immediately after each paclitaxel dose. Patients receive filgrastim (G-CSF) subcutaneously for 10-14 days after each of the first two paclitaxel and carboplatin doses. Radiotherapy begins on day 43 and is administered twice daily for 5 days per week for 6 weeks. Beginning on day 43, patients receive amifostine IV over 5-7 minutes 4 days a week for 6 weeks. Arm II: Patients receive treatment as in arm I without amifostine. Quality of life is assessed at baseline, before chemoradiation (after 2 courses of induction chemotherapy), the last week of chemoradiation (week 6), and at the 6-week follow-up visit. Patients are followed at 1 month, every 3 months for 1 year, every 6 months for 2 years, and then annually thereafter.

PROJECTED ACCRUAL: A total of 244 patients (122 per treatment arm) will be accrued for this study within 38 months.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
243
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Arm 1radiation therapyRadiation therapy and chemotherapy + Amifostine
Arm 2filgrastimRadiation therapy and chemotherapy alone
Arm 1filgrastimRadiation therapy and chemotherapy + Amifostine
Arm 1paclitaxelRadiation therapy and chemotherapy + Amifostine
Arm 1amifostine trihydrateRadiation therapy and chemotherapy + Amifostine
Arm 2radiation therapyRadiation therapy and chemotherapy alone
Arm 1carboplatinRadiation therapy and chemotherapy + Amifostine
Arm 2carboplatinRadiation therapy and chemotherapy alone
Arm 2paclitaxelRadiation therapy and chemotherapy alone
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (264)

University of Alabama at Birmingham Comprehensive Cancer Center

🇺🇸

Birmingham, Alabama, United States

Huntsville Hospital System

🇺🇸

Huntsville, Alabama, United States

Comprehensive Cancer Institute of Huntsville

🇺🇸

Huntsville, Alabama, United States

MBCCOP - Gulf Coast

🇺🇸

Mobile, Alabama, United States

Alabama Oncology, LLC

🇺🇸

Montgomery, Alabama, United States

Radiation Oncology Associates of West Alabama

🇺🇸

Tuscallosa, Alabama, United States

Providence Alaska Medical Center

🇺🇸

Anchorage, Alaska, United States

Foundation for Cancer Research and Education

🇺🇸

Phoenix, Arizona, United States

Arizona Cancer Center

🇺🇸

Tucson, Arizona, United States

University of Arkansas for Medical Sciences

🇺🇸

Little Rock, Arkansas, United States

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University of Alabama at Birmingham Comprehensive Cancer Center
🇺🇸Birmingham, Alabama, United States

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