Image-Guided Functional Lung Avoidance Thoracic Radiotherapy for Lung Cancer: A Single-Blind Randomized Trial
7. marts 2019 opdateret af: National Taiwan University Hospital
A Single-Blind Randomized Trial of Image-Guided Functional Lung Avoidance Thoracic Radiotherapy for Locally Advanced Non-Small Cell and Small Cell Lung Cancer
Thoracic radiotherapy (TRT) is a standard curative treatment for locally advanced, unresectable non-small cell lung cancer (NSCLC) and limited stage small cell lung cancer (SCLC).
TRT has been recognized to cause moderate to severe lung injury in a substantial portion of patients.
Conventional standard curative TRT planning techniques minimize the radiation dose to the anatomical lungs, without adaption of regional pulmonary function variations.
The principal investigator hypothesized that preferential avoidance of functional lung during curative TRT may decrease the risk of pulmonary toxicity.
Functional lung regions are identified using four- dimensional computed tomography for ventilation imaging.
This randomized, single-blind trial will comprehensively assess the impact of functional lung avoidance on pulmonary toxicity, quality of life, and clinical outcome in patients receiving curative TRT for locally advanced NSCLC and SCLC.
Studieoversigt
Status
Rekruttering
Intervention / Behandling
Undersøgelsestype
Interventionel
Tilmelding (Forventet)
64
Fase
- Ikke anvendelig
Kontakter og lokationer
Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.
Studiekontakt
- Navn: Feng-Ming Hsu, MD
- Telefonnummer: 67061 +886-2-23123456
- E-mail: hsufengming@ntuh.gov.tw
Studiesteder
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Taipei, Taiwan, 100
- Rekruttering
- National Taiwan University Hospital
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Kontakt:
- Feng-Ming Hsu, MD
- Telefonnummer: 67061 +886-2-23123456
- E-mail: hsufengming@ntuh.gov.tw
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Deltagelseskriterier
Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.
Berettigelseskriterier
Aldre berettiget til at studere
20 år og ældre (Voksen, Ældre voksen)
Tager imod sunde frivillige
Ingen
Køn, der er berettiget til at studere
Alle
Beskrivelse
Inclusion criteria:
- Patients with a histologic diagnosis of non-small cell carcinoma or small cell carcinoma of lung
- Locally advanced stage III A or III B lung carcinoma according to American Joint Committee on Cancer (AJCC) 7th edition or highly selected patients with oligo-metastatic disease amendable for thoracic radiotherapy with curative intent
- Not undergoing radical surgical resection
- Patients do not have prior radiotherapy to the thorax
- Age ≥ 20 years
- Karnofsky performance status (KPS) ≥ 60%.
- Women of childbearing potential and male participants must practice adequate contraception
- Patients must be able to comply with the study protocol and follow-up schedules and provide study-specific informed consent
Exclusion criteria:
- Prior radiotherapy to thorax
- Unable to receive assigned radiation dose due to normal lung constraint
- Inability to attend full course of radiotherapy or follow-up visits
- Presence of metastatic disease. Patients who present with oligo-metastatic disease where all metastases have been ablated (with surgery or radiotherapy) or in complete remission after systemic therapy are candidates if they are receiving radiotherapy to the thoracic disease with curative intent
Severe, active comorbidities which, in the judgment of the investigator, would make the patient inappropriate for entry into this study or interfere significantly with the proper assessment of safety and adverse events of the protocol, or limit compliance with study requirements, defined as follows:
- Uncontrolled active infection requiring intravenous antibiotics at the time of registration
- Transmural myocardial infarction ≤ 6 months prior to registration.
- Unstable angina or congestive heart failure requiring hospitalization ≤ 6 months prior to registration.
- Life-threatening uncontrolled clinically significant cardiac arrhythmias.
- Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects.
- Chronic obstructive pulmonary disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at the time of registration.
- Uncontrolled psychiatric disorder.
- Women of childbearing potential and male participants who are sexually active and not willing/able to use medically acceptable forms of contraception; this exclusion is necessary because the radiation treatment involved in this study may be significantly teratogenic.
- Pregnant or lactating women
Studieplan
Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Enkelt
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
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Eksperimentel: Functional Lung Avoidance-TRT
Functional Lung Avoidance Thoracic Radiotherapy The avoidance thoracic radiotherapy treatment plan will be designed to optimize such that radiation dose to functional lung identified by four-dimensional (4D) CT ventilation imaging is as low as reasonably achievable |
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Aktiv komparator: Standard-TRT
Standard Thoracic Radiotherapy The standard thoracic radiotherapy treatment plan will be designed without reference to the functional lung 4D CT ventilation imaging |
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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The pulmonary quality of life at 3 months post-radiotherapy
Tidsramme: Change from Baseline Functional Assessment of Cancer Therapy-Lung Cancer Subscale at 3 months
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Functional Assessment of Cancer Therapy-Lung Cancer Subscale (FACT-LCS)
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Change from Baseline Functional Assessment of Cancer Therapy-Lung Cancer Subscale at 3 months
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Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Samlet overlevelse
Tidsramme: Fra datoen for indskrivning til datoen for dødsfald uanset årsag, vurderet op til 60 måneder
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Antal deltagere i live
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Fra datoen for indskrivning til datoen for dødsfald uanset årsag, vurderet op til 60 måneder
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Changes of pulmonary function test post-radiotherapy
Tidsramme: At baseline, 3, 6, 12 months, and annually until year 5 post-radiotherapy
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Screening spirometry, diffusion capacity of lung for carbon monoxide
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At baseline, 3, 6, 12 months, and annually until year 5 post-radiotherapy
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Patient reported outcome (Quality of Life questionnaire by Functional Assessment of Cancer Therapy)
Tidsramme: At baseline, 1, 2, 3, 4, 6, 9 12 months post-radiotherapy
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Functional Assessment of Cancer Therapy-Lung
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At baseline, 1, 2, 3, 4, 6, 9 12 months post-radiotherapy
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Patient reported outcome (Quality of Life questionnaire by EORTC Core)
Tidsramme: At baseline, 1, 2, 3, 4, 6, 9 12 months post-radiotherapy
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EORTC Quality of Life-Core 30 questionnaire module
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At baseline, 1, 2, 3, 4, 6, 9 12 months post-radiotherapy
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Patient reported outcome (Quality of Life questionnaire by EORTC Lung cancer)
Tidsramme: At baseline, 1, 2, 3, 4, 6, 9 12 months post-radiotherapy
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EORTC Quality of Life questionnaire -Lung cancer 13
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At baseline, 1, 2, 3, 4, 6, 9 12 months post-radiotherapy
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Acute toxicity
Tidsramme: From date of radiotherapy until 90 days after radiotherapy starts
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Common Toxicity Criteria for Adverse Events version 4
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From date of radiotherapy until 90 days after radiotherapy starts
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Late toxicity
Tidsramme: 90 days after radiotherapy starts until the date of death from any cause, up to 60 months
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Common Toxicity Criteria for Adverse Events version 4
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90 days after radiotherapy starts until the date of death from any cause, up to 60 months
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Progression free survival
Tidsramme: From date of enrollment until the date of first documented disease progression or date of death from any cause, whichever came first, assessed up to 60 months
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Number of participant without disease progression
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From date of enrollment until the date of first documented disease progression or date of death from any cause, whichever came first, assessed up to 60 months
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Andre resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Serum biomarkers in association with radiation pneumonitis
Tidsramme: At baseline, 1, 2, 3, 4, 6 months post-radiotherapy
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Tumor necrosis factor-alpha, Transforming growth factor-beta concentration measured by ELISA
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At baseline, 1, 2, 3, 4, 6 months post-radiotherapy
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Samarbejdspartnere og efterforskere
Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.
Datoer for undersøgelser
Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.
Studer store datoer
Studiestart
1. juni 2016
Primær færdiggørelse (Forventet)
1. maj 2021
Studieafslutning (Forventet)
1. maj 2023
Datoer for studieregistrering
Først indsendt
27. juni 2016
Først indsendt, der opfyldte QC-kriterier
7. marts 2017
Først opslået (Faktiske)
13. marts 2017
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
11. marts 2019
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
7. marts 2019
Sidst verificeret
1. marts 2019
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- 201604007RINA
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
UBESLUTET
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Kliniske forsøg med Functional Lung Avoidance Thoracic Radiotherapy
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