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Comparable Study of Different Thoracic Radiotherapy Regimens for Extensive Stage Small Cell Lung Cancer

Not Applicable
Conditions
Carcinoma, Small Cell
Lung Neoplasms
Interventions
Radiation: high-dose TRT
Radiation: standard-dose TRT
Registration Number
NCT02675088
Lead Sponsor
Chinese Academy of Medical Sciences
Brief Summary

Most patients with extensive stage small-cell lung cancer (ES-SCLC) who undergo chemotherapy, and prophylactic cranial irradiation, have persistent intrathoracic disease. A Dutch study recently proved that thoracic radiotherapy(TRT), using 30 Gy in 10 fractions of 3 Gy, could improve 2-year overall survival(OS) of this patient group compared with non-TRT group. But intrathoracic progression was still high, either with or without progression elsewhere, occurring in 43.7% in the TRT group. The ideal TRT regimen for ES-SCLC is undefined. Maybe higher dose can provide better local control(LC) and overall survival. In this study, the investigators propose to give an increased dose of TRT to determine whether higher dose will improve 2-year OS, LC and progression-free survival.

Detailed Description

This is a multicenter, prospective, randomised phase III study. For patients with ES-SCLC who respond to chemotherapy after four to six cycles of standard chemotherapy (platinum etoposide), 45Gy/15F of thoracic radiotherapy will be used in experimental arm, while 30Gy/10F of thoracic radiotherapy will be used in the control arm. Both survival and toxicity of the two arms will be observed and compared.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
186
Inclusion Criteria
  • 18 - 70 years old, ECOG 0-2.
  • Patients with histologically or cytologically proved small cell lung cancer.
  • Extensive stage small-cell lung cancer (ES-SCLC), was characterized by tumors beyond the hemithorax, hilar, mediastinal, and supraclavicular nodes. According to 2007 AJCC cancer staging 7th edition, stage I-IIIB with lung metastases and stage IV should be defined as LD.
  • Has 1-4 extracranial metastatic lesions.
  • No brain or central nervous system (CNS) metastases.
  • No prior history of anti-tumor treatment.
  • Response after 4 to 6 cycles of EP-based chemotherapy within the past 4 weeks.
  • No severe internal diseases and no organ dysfunction.
  • Written informed consent provided.
Exclusion Criteria
  • Malignant tumors of other sites. Non melanoma skin cancer and Cervical carcinoma in situ were not included if curable.
  • Active heart disease or acute myocardial infarction happen in six months.
  • Psychiatric history.
  • Pregnant woman or woman need to breast feed or woman with positive chorionic gonadotrophin (HCG).
  • Uncontrolled diabetes or hypertension.
  • Interstitial pneumonia or Active pulmonary fibrosis.
  • Acute bacterial or fungal infection.
  • Oral or intravenous use of steroids.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
high-dose TRThigh-dose TRThigh-dose thoracic radiotherapy X-ray RT
standard-dose TRTstandard-dose TRTstandard-dose thoracic radiotherapy XRT
Primary Outcome Measures
NameTimeMethod
overall survival2 years

The time interval between diagnosis and death

Secondary Outcome Measures
NameTimeMethod
Incidence of tumor recurrence in local or regional area2 years

Number of patients experienceing recurrences in local or regional area divided by number of all enrolled patients

Incidence of radiotherapy and chemotherapy induced toxicities assessed by CTCAE v 4.02 years

Number of patients experienceing any toxicities induced by radiotherapy or chemotherapy divided by number of all enrolled patients

progression-free survival2 years

The time interval between diagnosis and disease progression

Trial Locations

Locations (2)

Cancer Insititute and Hosiptal of Chinese Academy of Medical Sciences

🇨🇳

Beijing, Beijing, China

Zhejiang Cancer Hospital

🇨🇳

Hangzhou, Zhejiang, China

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