- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02337712
Once-daily Simultaneous Modulated Accelerated Thoracic Radiotherapy in Limited Small-cell Lung Cancer
Once-daily Simultaneous Modulated Accelerated Thoracic Radiotherapy Compared With Twice-daily Radiotherapy in Limited Small-cell Lung Cancer Treated Concurrently With Cisplatin and Etoposide
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This Phase II randomized study is to determine whether once-daily (qd)simultaneous modulated accelerated thoracic radiotherapy resulted in better survival than twice-daily(bid) RT for patients with limited-stage small-cell lung cancer (LD-SCLC).
All patients receive four to six cycles of etoposide and cisplatin (EP) every 3 weeks. Thoracic RT is initiated with cycle 1-3 of chemotherapy. Qd RT includes the delivery of 65 Gy in 26 fractions delivered on weekdays for a total of 33 days. Bid RT includes the delivery of 45 Gy in 30 fractions delivered on weekdays for a total of 19 days. After the chest RT and the last cycle of EP, prophylactic cranial irradiation is administered to those patients with a complete or partial remission.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Guangdong
-
Guangzhou, Guangdong, China, 510000
- Sun Yat-sen University Cancer Center
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Pathologic confirmation of SCLC. Imaging studies' confirmation of limited stage.
- No previous chest radiotherapy, chemotherapy or biotherapy.
- Patients have measurable or evaluable lesions based on the Response Evaluation Criteria in Solid Tumors (RECIST) criteria.
- White blood cell count ≥4×109 /L, platelet count≥100×109 /L, hemoglobin ≥100 g /L; serum creatinine and total bilirubin 1.5 times or less the upper limits of normal (ULN), aspartate aminotransferase two times or less the ULN.
- Eastern Cooperative Oncology Group (ECOG) performance status 0-1.
- Weight loss ≤10% within the past 3 months.
- Forced expiratory volume in 1 s >1 L.
Exclusion Criteria:
- Previous or recent another malignancy.
- A myocardial infarction within 6 months or had uncontrolled congestive heart failure, uncontrolled arrhythmia.
- Malignant pleural or pericardial effusion.
- Pregnant or Lactating.
- Weight loss >10% within the past 3 months.
- Drug addiction, long-term alcohol abuse and AIDS patients.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Experimental: q.d. RT
q.d.
RT (65 Gy in 26 fractions) to the chest and concurrent etoposide and cisplatin
|
65 Gy in 26 fractions
etoposide and cisplatin concurrent with radiotherapy
|
|
Active Comparator: b.i.d.RT
b.i.d.RT (45Gy in 30 fractions) to the chest and concurrent etoposide and cisplatin
|
etoposide and cisplatin concurrent with radiotherapy
45 Gy in 30 fractions
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
progression-free survival
Time Frame: 2 years
|
2 years
|
Collaborators and Investigators
Sponsor
Publications and helpful links
General Publications
- Fan TY, Xing J, Lu J, Liu TH, Xu M, Zhang YJ, Shao Q, Li JB, Yu JM. Phase I/II study of induction chemotherapy plus concurrent chemotherapy and SMART-IMRT-based radiotherapy in locoregionally-advanced nasopharyngeal cancer. Oncol Lett. 2013 Mar;5(3):889-895. doi: 10.3892/ol.2013.1137. Epub 2013 Jan 15.
- Turrisi AT 3rd, Kim K, Blum R, Sause WT, Livingston RB, Komaki R, Wagner H, Aisner S, Johnson DH. Twice-daily compared with once-daily thoracic radiotherapy in limited small-cell lung cancer treated concurrently with cisplatin and etoposide. N Engl J Med. 1999 Jan 28;340(4):265-71. doi: 10.1056/NEJM199901283400403.
- Kong FM, Lally BE, Chang JY, Chetty IJ, Decker RH, Ginsburg ME, Kestin LL, Langer CJ, Movsas B, Videtic GM, Willers H, Rosenzweig KE; Expert Panel on Radiation Oncology-Lung. ACR Appropriateness Criteria(R) radiation therapy for small-cell lung cancer. Am J Clin Oncol. 2013 Apr;36(2):206-13. doi: 10.1097/COC.0b013e31827e5523.
- Socinski MA, Bogart JA. Limited-stage small-cell lung cancer: the current status of combined-modality therapy. J Clin Oncol. 2007 Sep 10;25(26):4137-45. doi: 10.1200/JCO.2007.11.5303.
- Chen GY, Jiang GL, Wang LJ, Qian H, Fu XL, Yang H, Wu KL, Zhao S. Cisplatin/etoposide chemotherapy combined with twice daily thoracic radiotherapy for limited small-cell lung cancer: a clinical phase II trial. Int J Radiat Oncol Biol Phys. 2005 Jan 1;61(1):70-5. doi: 10.1016/j.ijrobp.2004.04.058.
- Hu X, Bao Y, Zhang L, Guo Y, Chen YY, Li KX, Wang WH, Liu Y, He H, Chen M. Omitting elective nodal irradiation and irradiating postinduction versus preinduction chemotherapy tumor extent for limited-stage small cell lung cancer: interim analysis of a prospective randomized noninferiority trial. Cancer. 2012 Jan 1;118(1):278-87. doi: 10.1002/cncr.26119. Epub 2011 May 19.
- Choi NC, Herndon JE 2nd, Rosenman J, Carey RW, Chung CT, Bernard S, Leone L, Seagren S, Green M. Phase I study to determine the maximum-tolerated dose of radiation in standard daily and hyperfractionated-accelerated twice-daily radiation schedules with concurrent chemotherapy for limited-stage small-cell lung cancer. J Clin Oncol. 1998 Nov;16(11):3528-36. doi: 10.1200/JCO.1998.16.11.3528.
- Roof KS, Fidias P, Lynch TJ, Ancukiewicz M, Choi NC. Radiation dose escalation in limited-stage small-cell lung cancer. Int J Radiat Oncol Biol Phys. 2003 Nov 1;57(3):701-8. doi: 10.1016/s0360-3016(03)00715-6.
- Miller AA, Wang XF, Bogart JA, Hodgson LD, Rocha Lima CM, Radford JE, Vokes EE, Green MR; Cancer and Leukemia Group B (CALGB). Phase II trial of paclitaxel-topotecan-etoposide followed by consolidation chemoradiotherapy for limited-stage small cell lung cancer: CALGB 30002. J Thorac Oncol. 2007 Jul;2(7):645-51. doi: 10.1097/JTO.0b013e318074bbf5.
- Bogart JA, Herndon JE 2nd, Lyss AP, Watson D, Miller AA, Lee ME, Turrisi AT, Green MR; Cancer and Leukemia Group B study 39808. 70 Gy thoracic radiotherapy is feasible concurrent with chemotherapy for limited-stage small-cell lung cancer: analysis of Cancer and Leukemia Group B study 39808. Int J Radiat Oncol Biol Phys. 2004 Jun 1;59(2):460-8. doi: 10.1016/j.ijrobp.2003.10.021.
- Liao ZX, Komaki RR, Thames HD Jr, Liu HH, Tucker SL, Mohan R, Martel MK, Wei X, Yang K, Kim ES, Blumenschein G, Hong WK, Cox JD. Influence of technologic advances on outcomes in patients with unresectable, locally advanced non-small-cell lung cancer receiving concomitant chemoradiotherapy. Int J Radiat Oncol Biol Phys. 2010 Mar 1;76(3):775-81. doi: 10.1016/j.ijrobp.2009.02.032. Epub 2009 Jun 8.
- Shirvani SM, Juloori A, Allen PK, Komaki R, Liao Z, Gomez D, O'Reilly M, Welsh J, Papadimitrakopoulou V, Cox JD, Chang JY. Comparison of 2 common radiation therapy techniques for definitive treatment of small cell lung cancer. Int J Radiat Oncol Biol Phys. 2013 Sep 1;87(1):139-47. doi: 10.1016/j.ijrobp.2013.05.040.
- Xia B, Chen GY, Cai XW, Zhao JD, Yang HJ, Fan M, Zhao KL, Fu XL. Is involved-field radiotherapy based on CT safe for patients with limited-stage small-cell lung cancer? Radiother Oncol. 2012 Feb;102(2):258-62. doi: 10.1016/j.radonc.2011.10.003. Epub 2011 Nov 5.
- Murray N, Coy P, Pater JL, Hodson I, Arnold A, Zee BC, Payne D, Kostashuk EC, Evans WK, Dixon P, et al. Importance of timing for thoracic irradiation in the combined modality treatment of limited-stage small-cell lung cancer. The National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol. 1993 Feb;11(2):336-44. doi: 10.1200/JCO.1993.11.2.336.
- Giuliani ME, Lindsay PE, Sun A, Bezjak A, Le LW, Brade A, Cho J, Leighl NB, Shepherd FA, Hope AJ. Locoregional failures following thoracic irradiation in patients with limited-stage small cell lung carcinoma. Radiother Oncol. 2012 Feb;102(2):263-7. doi: 10.1016/j.radonc.2011.12.009. Epub 2012 Jan 28.
- Yee D, Hanson J, Butts C, Reiman A, Joy A, Smylie M, Fenton D, Chu Q, Roa W. Phase I dose escalation trial of hypofractionated limited-field external beam thoracic radiotherapy for limited-stage small cell carcinoma of the lung. Radiother Oncol. 2010 Jul;96(1):78-83. doi: 10.1016/j.radonc.2010.05.013. Epub 2010 Jun 11.
- Qiu B, Li Q, Liu J, Huang Y, Pang Q, Zhu Z, Yang X, Wang B, Chen L, Fang J, Lin M, Jiang X, Guo S, Guo J, Wang D, Liu F, Chu C, Huang X, Xie C, Liu H. Moderately Hypofractionated Once-Daily Compared With Twice-Daily Thoracic Radiation Therapy Concurrently With Etoposide and Cisplatin in Limited-Stage Small Cell Lung Cancer: A Multicenter, Phase II, Randomized Trial. Int J Radiat Oncol Biol Phys. 2021 Oct 1;111(2):424-435. doi: 10.1016/j.ijrobp.2021.05.003. Epub 2021 May 13.
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Respiratory Tract Diseases
- Neoplasms
- Lung Diseases
- Neoplasms by Site
- Respiratory Tract Neoplasms
- Thoracic Neoplasms
- Carcinoma, Bronchogenic
- Bronchial Neoplasms
- Lung Neoplasms
- Small Cell Lung Carcinoma
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Antineoplastic Agents
- Antineoplastic Agents, Phytogenic
- Topoisomerase II Inhibitors
- Topoisomerase Inhibitors
- Etoposide
- Cisplatin
Other Study ID Numbers
- 2014-FXY-037
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