A Phase I Dose Intensification Study Using Gated Intensity Modulated Radiation Therapy and Concurrent Chemotherapy for Patients With Inoperable, Non-Small Cell Lung Cancer
试验速览
- 阶段
- 1 期
- 状态
- 终止
- 入组人数
- 28
- 试验地点
- 2
- 主要终点
- Maximum tolerated dose
研究概览
简要总结
Radiation therapy technology that allows increased radiation dose to the tumor while sparing healthy tissue will improve the balance between complications and cure.
详细描述
The primary objective is to establish the maximum tolerated fractional dose (MTfD) of radiotherapy to a total dose of 78Gy using gated IMRT, delivered in single daily fractions that can be administered concurrently with Taxol® and carboplatin chemotherapy. Secondary objectives include: to evaluate the toxicity of concurrent Taxol® and carboplatin with gated IMRT; identify partial organ tolerance doses for lung and esophagus when treating with involved field thoracic 3D; estimate complete response rate as defined by PET performed 3 months after completion of all therapy.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients with histologically-proven, by biopsy or cytology, unresectable lung cancer of the following histologic types: squamous cell carcinoma, adenocarcinoma, large cell carcinoma, non-small cell carcinoma, not otherwise specified.
- •Patient with AJCC Stage IIIA-IIIB, if all detectable tumor can be encompassed by radiation therapy fields, including both the primary tumor and the involved regional lymph nodes.
- •18-fluoro-2-deoxyglucose positron emission tomography required for staging and image fusion for treatment planning.
- •Atelectasis, if present, must be less than one lung.
- •Patients must have granulocytes >1500/µl; platelets >100,000/µl; bilirubin < 1.5 mg/dl; AST(SGOT) < 2 ULN; serum creatinine < 2.0 mg/dl.
- •Zubrod Score 0-
- •FEV1 must be >1.0 L.
- •Patients must sign a study-specific informed consent form prior to study entry
- •Patients must have measurable disease on the planning CT.
- •Patient must have a completed the IMRT plan and the attending physician must have reviewed and approved the dose volume histograms as follows (based on treatment planning to the Phase 4 dose level): total lung V20 < 30%, mean esophageal dose < 34 Gy, the esophageal V55 < 30%, the heart V40 < 50%.
- •No prior or concurrent malignancy except non-melanomatous skin cancer unless disease-free for one year or more; no prior lung cancer within last two years.
- •No prior RT to thorax.
- •No previous chemotherapy or previous biologic response modifiers for current lung cancer or within the past five (5) years.
- •No distant metastases or supraclavicular lymph node involvement or significant atelectasis.
- •No clinically significant pleural effusions, pericardial effusions or superior vena cava syndrome.
排除标准
- •Undifferentiated small cell (oat cell or high grade neuroendocrine) carcinoma, any stage.
- •Stage I, II or IV NSCLC.
- •Complete tumor resection, recurrent disease, or those patients eligible for definitive surgery.
- •Concurrent malignancy except non-melanomatous skin cancer or prior cancer unless disease-free for one year or more.
- •Prior radiation therapy to the thorax.
- •Previous chemotherapy or previous biologic response modifiers for current lung cancer or within the past five (5) years.
- •Distant metastases or supraclavicular lymph node involvement, or atelectasis of an entire lung.
- •Patients who have not had the pre-treatment evaluations in Section 4.0 or evaluations performed > 8 weeks prior to study entry.
- •Patients with clinically significant pleural effusions, pericardial effusions or superior vena cava syndrome.
- •Prior lung cancer within the last two years.
- •Patients who have significant atelectasis and in whom the CT definition of the gross tumor volume(GTV) is difficult to determine.
- •Pregnant or lactating females. It is not known what effects this treatment may have on the developing fetus.
结局指标
主要结局
Maximum tolerated dose
时间窗: 3 years
次要结局
- To identify partial organ tolerance doses for lung and esophagus when treating with involved field thoracic 3D. To estimate complete response rate as defined by PET performed 3 months after completion of all therapy.(3 years)
