Proton Therapy for Stage I Non-Small Cell Lung Cancer (LU03)

NCT00875901 | Completed DMC

• 1 other identifier: UFPTI 0901 - LU03
• Study Type: interventional
• Target: 23
• Locations: 1 country
• Sites: 1

Brief Summary

This is a research study to determine if hypofractionated image guided radiation therapy (hypoIGRT) with proton therapy is a good way to treat early stage lung tumors for patients who will not have surgery. HypoIGRT delivers higher daily doses of radiation over a shorter period of time compared with conventional radiation. This is thought to deliver a more lethal dose of radiation to the tumor and is more convenient with treatment being completed within 2-3 weeks compared to the typical 7-8 week course of conventional radiotherapy.

Conditions

Non-Small Cell Lung Cancer

Keywords

Lung Cancer; Stage I Non-Small Cell Lung Cancer; Proton Radiation; HypoIGRT

Outcome Measures

Primary Outcomes (1)

• Confirm Grade 3 or higher toxicity rate of hypoIGRT proton therapy in patients with stage I non-small cell lung cancer.

  1 year after the end of radiation therapy

Secondary Outcomes (3)

• Collect and analyze outcome data on tumor control and survival

  When each patient has been followed for a minimum of 12 months to a maximum of 5 years

• Assess differences in dosimetric values compared with photons for lung, heart, esophagus, spinal cord, skin and brachial plexus

  When each patient has been followed for a minimum of 12 months to a maximum of 5 years

• Assess changes in quality of life before and after treatment

  Before treatment and then when each patient has been followed for a minimum of 12 months to a maxiumum of 5 years

Study Arms (2)

Peripherally located lung tumor

EXPERIMENTAL

12 cobalt gray equivalent per fraction to a total of 48 cobalt gray equivalent

Radiation: Peripherally located lung tumor

Centrally located lung tumor

EXPERIMENTAL

6 cobalt gray equivalent per fraction to a total of 60 cobalt gray equivalent

Radiation: Centrally located lung tumor

Interventions

Peripherally located lung tumor RADIATION

12 cobalt gray equivalent per fraction for 4 fractions, 2-3 treatments per week (every other day), over 2 weeks for a total of 48 cobalt gray equivalent (Fractions at lest 40 hours apart)

Also known as: Proton Radiation

Peripherally located lung tumor

Centrally located lung tumor RADIATION

6 cobalt gray equivalent per fraction for 10 fractions, 5 treatments per week over 2-3 weeks for a total of 60 cobalt gray equivalent (no more than one fraction per calendar day)

Also known as: Proton Radiation

Centrally located lung tumor

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Pathologically confirmed, by biopsy or cytology, non-small cell lung carcinoma diagnosed within 3 months prior to study enrollment.
• T1, N0, M0 or T2, N0, M0. (AJCC Lung 7th Edition)
• At least 18 years old at the time of consent.
• Adequate bone marrow function.
• Medically inoperable. Medically operable candidates are allowed if they refuse surgical resection.
• If the patient has a large pleural effusion, it must be biopsy negative.

You may not qualify if:

• Evidence of distant metastasis (M1) and/or nodal involvement (N1, N2, N3).
• Synchronous primary.
• T2 tumors \> 5 cm; T3, T4 primary tumor.
• Previous radiotherapy for lung cancer.
• Concomitant local, regional, and/or systemic therapy during radiotherapy.
• Active systemic, pulmonary, and/or pericardial infection.

Sponsors & Collaborators

• University of Florida: lead

Study Sites (1)

University of Florida Proton Therapy Institute

Jacksonville, Florida, 32206, United States

Location

Related Publications (23)

• Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T, Thun MJ. Cancer statistics, 2008. CA Cancer J Clin. 2008 Mar-Apr;58(2):71-96. doi: 10.3322/CA.2007.0010. Epub 2008 Feb 20.

  PMID: 18287387 BACKGROUND

• al-Kattan K, Sepsas E, Fountain SW, Townsend ER. Disease recurrence after resection for stage I lung cancer. Eur J Cardiothorac Surg. 1997 Sep;12(3):380-4. doi: 10.1016/s1010-7940(97)00198-x.

  PMID: 9332915 BACKGROUND

• Suzuki K, Nagai K, Yoshida J, Moriyama E, Nishimura M, Takahashi K, Nishiwaki Y. Prognostic factors in clinical stage I non-small cell lung cancer. Ann Thorac Surg. 1999 Apr;67(4):927-32. doi: 10.1016/s0003-4975(99)00140-x.

  PMID: 10320230 BACKGROUND

• van Rens MT, de la Riviere AB, Elbers HR, van Den Bosch JM. Prognostic assessment of 2,361 patients who underwent pulmonary resection for non-small cell lung cancer, stage I, II, and IIIA. Chest. 2000 Feb;117(2):374-9. doi: 10.1378/chest.117.2.374.

  PMID: 10669677 BACKGROUND

• Dosoretz DE, Galmarini D, Rubenstein JH, Katin MJ, Blitzer PH, Salenius SA, Dosani RA, Rashid M, Mestas G, Hannan SE, et al. Local control in medically inoperable lung cancer: an analysis of its importance in outcome and factors determining the probability of tumor eradication. Int J Radiat Oncol Biol Phys. 1993 Oct 20;27(3):507-16. doi: 10.1016/0360-3016(93)90373-4.

  PMID: 8226142 BACKGROUND

• Dosoretz DE, Katin MJ, Blitzer PH, Rubenstein JH, Salenius S, Rashid M, Dosani RA, Mestas G, Siegel AD, Chadha TT, et al. Radiation therapy in the management of medically inoperable carcinoma of the lung: results and implications for future treatment strategies. Int J Radiat Oncol Biol Phys. 1992;24(1):3-9. doi: 10.1016/0360-3016(92)91013-d.

  PMID: 1324899 BACKGROUND

• Gauden S, Ramsay J, Tripcony L. The curative treatment by radiotherapy alone of stage I non-small cell carcinoma of the lung. Chest. 1995 Nov;108(5):1278-82. doi: 10.1378/chest.108.5.1278.

  PMID: 7587429 BACKGROUND

• Baumann P, Nyman J, Lax I, Friesland S, Hoyer M, Rehn Ericsson S, Johansson KA, Ekberg L, Morhed E, Paludan M, Wittgren L, Blomgren H, Lewensohn R. Factors important for efficacy of stereotactic body radiotherapy of medically inoperable stage I lung cancer. A retrospective analysis of patients treated in the Nordic countries. Acta Oncol. 2006;45(7):787-95. doi: 10.1080/02841860600904862.

  PMID: 16982541 BACKGROUND

• Fritz P, Kraus HJ, Blaschke T, Muhlnickel W, Strauch K, Engel-Riedel W, Chemaissani A, Stoelben E. Stereotactic, high single-dose irradiation of stage I non-small cell lung cancer (NSCLC) using four-dimensional CT scans for treatment planning. Lung Cancer. 2008 May;60(2):193-9. doi: 10.1016/j.lungcan.2007.10.005. Epub 2007 Nov 28.

  PMID: 18045732 BACKGROUND

• Lagerwaard FJ, Haasbeek CJ, Smit EF, Slotman BJ, Senan S. Outcomes of risk-adapted fractionated stereotactic radiotherapy for stage I non-small-cell lung cancer. Int J Radiat Oncol Biol Phys. 2008 Mar 1;70(3):685-92. doi: 10.1016/j.ijrobp.2007.10.053. Epub 2007 Dec 31.

  PMID: 18164849 BACKGROUND

• Onishi H, Shirato H, Nagata Y, Hiraoka M, Fujino M, Gomi K, Niibe Y, Karasawa K, Hayakawa K, Takai Y, Kimura T, Takeda A, Ouchi A, Hareyama M, Kokubo M, Hara R, Itami J, Yamada K, Araki T. Hypofractionated stereotactic radiotherapy (HypoFXSRT) for stage I non-small cell lung cancer: updated results of 257 patients in a Japanese multi-institutional study. J Thorac Oncol. 2007 Jul;2(7 Suppl 3):S94-100. doi: 10.1097/JTO.0b013e318074de34.

  PMID: 17603311 BACKGROUND

• Timmerman R, McGarry R, Yiannoutsos C, Papiez L, Tudor K, DeLuca J, Ewing M, Abdulrahman R, DesRosiers C, Williams M, Fletcher J. Excessive toxicity when treating central tumors in a phase II study of stereotactic body radiation therapy for medically inoperable early-stage lung cancer. J Clin Oncol. 2006 Oct 20;24(30):4833-9. doi: 10.1200/JCO.2006.07.5937.

  PMID: 17050868 BACKGROUND

• Xia T, Li H, Sun Q, Wang Y, Fan N, Yu Y, Li P, Chang JY. Promising clinical outcome of stereotactic body radiation therapy for patients with inoperable Stage I/II non-small-cell lung cancer. Int J Radiat Oncol Biol Phys. 2006 Sep 1;66(1):117-25. doi: 10.1016/j.ijrobp.2006.04.013. Epub 2006 Jun 9.

  PMID: 16765528 BACKGROUND

• Hof H, Muenter M, Oetzel D, Hoess A, Debus J, Herfarth K. Stereotactic single-dose radiotherapy (radiosurgery) of early stage nonsmall-cell lung cancer (NSCLC). Cancer. 2007 Jul 1;110(1):148-55. doi: 10.1002/cncr.22763.

  PMID: 17516437 BACKGROUND

• Zimmermann FB, Geinitz H, Schill S, Thamm R, Nieder C, Schratzenstaller U, Molls M. Stereotactic hypofractionated radiotherapy in stage I (T1-2 N0 M0) non-small-cell lung cancer (NSCLC). Acta Oncol. 2006;45(7):796-801. doi: 10.1080/02841860600913210.

  PMID: 16982542 BACKGROUND

• Yamashita H, Nakagawa K, Nakamura N, Koyanagi H, Tago M, Igaki H, Shiraishi K, Sasano N, Ohtomo K. Exceptionally high incidence of symptomatic grade 2-5 radiation pneumonitis after stereotactic radiation therapy for lung tumors. Radiat Oncol. 2007 Jun 7;2:21. doi: 10.1186/1748-717X-2-21.

  PMID: 17553175 BACKGROUND

• Onimaru R, Shirato H, Shimizu S, Kitamura K, Xu B, Fukumoto S, Chang TC, Fujita K, Oita M, Miyasaka K, Nishimura M, Dosaka-Akita H. Tolerance of organs at risk in small-volume, hypofractionated, image-guided radiotherapy for primary and metastatic lung cancers. Int J Radiat Oncol Biol Phys. 2003 May 1;56(1):126-35. doi: 10.1016/s0360-3016(03)00095-6.

  PMID: 12694831 BACKGROUND

• Georg D, Hillbrand M, Stock M, Dieckmann K, Potter R. Can protons improve SBRT for lung lesions? Dosimetric considerations. Radiother Oncol. 2008 Sep;88(3):368-75. doi: 10.1016/j.radonc.2008.03.007. Epub 2008 Apr 9.

  PMID: 18405986 BACKGROUND

• Bush DA, Slater JD, Shin BB, Cheek G, Miller DW, Slater JM. Hypofractionated proton beam radiotherapy for stage I lung cancer. Chest. 2004 Oct;126(4):1198-203. doi: 10.1378/chest.126.4.1198.

  PMID: 15486383 BACKGROUND

• Miyamoto T, Baba M, Sugane T, Nakajima M, Yashiro T, Kagei K, Hirasawa N, Sugawara T, Yamamoto N, Koto M, Ezawa H, Kadono K, Tsujii H, Mizoe JE, Yoshikawa K, Kandatsu S, Fujisawa T; Working Group for Lung Cancer. Carbon ion radiotherapy for stage I non-small cell lung cancer using a regimen of four fractions during 1 week. J Thorac Oncol. 2007 Oct;2(10):916-26. doi: 10.1097/JTO.0b013e3181560a68.

  PMID: 17909354 BACKGROUND

• Lagerwaard FJ et al Quality of life after stereotactic radiotherapy for medically inoperable stage I lung cancer. International Journal of Radiation Oncology, Biology, Physics IJROBP 2006 Nov1;66(3): S133-S134

  BACKGROUND

• Brown J, Thorpe H, Napp V, Fairlamb DJ, Gower NH, Milroy R, Parmar MK, Rudd RM, Spiro SG, Stephens RJ, Waller D, West P, Peake MD. Assessment of quality of life in the supportive care setting of the big lung trial in non-small-cell lung cancer. J Clin Oncol. 2005 Oct 20;23(30):7417-27. doi: 10.1200/JCO.2005.09.158. Epub 2005 Sep 12.

  PMID: 16157935 BACKGROUND

• Li WW, Lee TW, Lam SS, Ng CS, Sihoe AD, Wan IY, Yim AP. Quality of life following lung cancer resection: video-assisted thoracic surgery vs thoracotomy. Chest. 2002 Aug;122(2):584-9. doi: 10.1378/chest.122.2.584.

  PMID: 12171836 BACKGROUND

MeSH Terms

Conditions

Carcinoma, Non-Small-Cell Lung; Lung Neoplasms

Interventions

Proton Therapy

Condition Hierarchy (Ancestors)

Carcinoma, Bronchogenic; Bronchial Neoplasms; Respiratory Tract Neoplasms; Thoracic Neoplasms; Neoplasms by Site; Neoplasms; Lung Diseases; Respiratory Tract Diseases

Intervention Hierarchy (Ancestors)

Heavy Ion Radiotherapy; Radiotherapy; Therapeutics

Study Officials

• Romaine C Nichols, MD

  University of Florida Proton Therapy Institute

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 2, 2009
• First Posted: April 6, 2009
• Study Start: September 1, 2009
• Primary Completion: March 21, 2022
• Study Completion: March 21, 2022
• Last Updated: March 24, 2022

Record last verified: 2022-03

Locations

US (1)