Stage I-III Small Cell Lung Cancer Clinical Trial
Official title:
Concurrent Chemo-radiotherapy With IMRT for Stage I-III Small Cell Lung Cancer
The investigators' group was the first to perform a phase II trial in patients with limited disease (stage I-III) small-cell lung carcinoma (SCLC) in which only the fluorodeoxyglucose-positron emission tomography (FDG-PET) positive lymph nodes were irradiated. In this trial, only 3% of isolated nodal failures were observed. However, all patients in that study were treated with 3D conformal radiotherapy (3DCRT). At present, IMRT techniques have become more standard in lung cancer. Because of the lower radiation dose to the lymph nodes outside of the planning target volume (PTV) with IMRT, higher incidences of isolated nodal failures may occur. In this trial, the investigators will investigate the patterns of local relapse after IMRT with concurrent chemotherapy in patients with stage I-III SCLC.
Eligible patients (see below) will receive radiotherapy to the primary tumor and the
initially involved mediastinal lymph nodes on FDG-PET scan to a dose of 45Gy in 30 fractions
in 3 weeks (1.5Gy BID). Radiotherapy will be delivered concurrently with cisplatin (or in
case of a creatinin clearance of <60ml/min, carboplatin) and etoposide chemotherapy. When
after 4 cycles of chemotherapy and concurrent chest radiotherapy, no disease progression is
observed and the WHO performance status is 0-2, PCI (prophylactic cranial irradiation) will
bee offered to a dose of 25 Gy in 10 daily fractions.
The radiation doses will be specified according to ICRU 50. Lung density corrections will be
applied, as well as all standard QA procedures. Technical requirements are the same as in
standard practice at MAASTRO clinic.
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