Lung Cancer Clinical Trial
Official title:
A Phase I/II Study of Hypofractionated Stereotactic Body Radiotherapy for Stage I/II Non-small Cell Lung Cancer Within the Central Lung Region and the Prognostic Impact of FDG Positron Emission Tomography
RATIONALE: Stereotactic body radiation therapy may be able to send x-rays directly to the
tumor and cause less damage to normal tissue.
PURPOSE: This phase I/II trial is studying the side effects and best dose of stereotactic
body radiation therapy and to see how well it works in treating patients with stage I or
stage II non-small cell lung cancer.
OBJECTIVES:
Primary
- Determine the maximum tolerated dose of hypofractionated stereotactic body radiotherapy
(SBRT) to the central lung region (peri-mediastinum) in patients with stage I or II
non-small cell lung cancer. (Phase I)
- Determine local control and time to local progression in patients treated with this
regimen. (Phase II)
- Evaluate the ability of peak standardized uptake values (SUV) for fludeoxyglucose F 18
(FDG)-PET scan, obtained shortly after SBRT (post-treatment), to predict local control
and time to progression in these patients.
Secondary
- Evaluate the ability of maximum SUV for FDG-PET scan, obtained shortly after SBRT, to
predict long-term local control and time to progression in these patients.
- Evaluate the ability of peak SUV and max SUV for FDG-PET scan, obtained prior to SBRT,
to predict local control and time to progression in these patients.
- Determine the utility of PET/CT scan data in guiding treatment planning.
- Determine if treatment with radiotherapy involving high biological doses with limited
treatment volume using these SBRT techniques achieves acceptable treatment-related
toxicity.
OUTLINE: This is a phase I dose-escalation study followed by a phase II open-label study.
- Phase I: Patients undergo hypofractionated stereotactic body radiotherapy (SBRT) 3
times within a 2-week time frame.
Cohorts of 3-6 patients receive escalating doses of hypofractionated SBRT until the maximum
tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which 2
of 3 or 2 of 6 patients experience dose-limiting toxicity.
- Phase II: Patients undergo hypofractionated SBRT at the MTD as in phase I. In both
phases, patients undergo fludeoxyglucose F 18-PET/CT scans at baseline and at 12-16
weeks after completion of SBRT.
After completion of study treatment, patients are followed periodically for 4 years.
PROJECTED ACCRUAL: A total of 90 patients will be accrued for this study.
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