Lung Cancer Clinical Trial
Official title:
A Randomized Phase III Study of Sublobar Resection Versus Sublobar Resection Plus Brachytherapy in High Risk Patients With Non-Small Cell Lung Cancer (NSCLC), 3cm or Smaller
This randomized phase III trial studies surgery and internal radiation therapy to see how well they work compared to surgery alone in treating patients with stage I non-small cell lung cancer. Surgery may be an effective treatment for non-small cell lung cancer. Internal radiation uses radioactive material placed directly into or near a tumor to kill tumor cells. It is not yet known whether surgery and internal radiation therapy are more effective than surgery alone in treating non-small cell lung cancer.
PRIMARY OBJECTIVES:
I. To ascertain whether patients treated by sublobar resection (SR) + brachytherhapy (BX)
have longer time to local recurrence as compared to the patients treated by SR (local
recurrence includes recurrence within the same lobe or hilum [N1 nodes], or progression at
the staple line after treatment effects such as scarring have subsided).
SECONDARY OBJECTIVES:
I. To compare procedure specific morbidity and mortality between study arms. II. To compare
overall survival and failure-free survival between study arms. III. To assess freedom from
regional or distant recurrence. IV. To assess the effect of histological or cytologic
positive resection margins on time to local recurrence.
V. To determine the effect of brachytherapy on quality of life (QoL). VI. To determine the
effect of brachytherapy on pulmonary function.
OUTLINE: Patients are randomized to 1 of 2 treatment arms.
ARM I: Patients undergo open or thoracoscopic sublobar resection comprising either a wedge
resection or anatomical segmentectomy.
ARM II: Patients undergo surgery as in arm I. Patients also undergo intraoperative
brachytherapy comprising iodine I 125 implant at the resection margin.
After completion of study treatment, patients are followed at 3, 6, 12, 18, 24, 30, and 36
months and then yearly for 2 years.
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