Lung Cancer Clinical Trial
Official title:
Pulmonary Interstitial Lymphography in Early Stage Lung Cancer
The stereotactic body radiation therapy (SBRT) procedure is an emerging alternative to the
standard treatment for early stage non-small cell lung cancer (NSCLC), typically lobectomy
with lymphadenectomy. This procedure (lobectomy) does not fulfill the medical need as many
patients are poor operative candidates or decline surgery.
This study assesses the feasibility of stereotactic body radiation therapy (SBRT) as a tool
to produce therapeutically useful computed tomography (CT) scans, using standard
water-soluble iodinated compounds as the contrast agents.
Non-small cell lung cancer (NSCLC) is the most deadly cancer in the world. NSCLC annually
causes 150,000 deaths in the US and greater than 1 million worldwide. The standard treatment
for early stage NSCLC is lobectomy with lymphadenectomy. However, many patients are poor
operative candidates or decline surgery. An emerging alternative is Stereotactic Body
Radiation Therapy (SBRT). Mounting evidence from phase 1-2 studies demonstrates that SBRT
offers excellent local control. Most SBRT trials focused on small, peripheral tumors in
inoperable patients. Increasingly, clinical trials study SBRT in operable patients, often
with larger, central tumors.
Using clinical staging, a significant proportion of patients harbor occult nodal metastases
when undergoing SBRT to the primary tumor alone. Subgroups of patients carry even higher risk
of nodal metastases. These nodal metastases frequently would be removed by surgical
intervention. However, SBRT, at present, is only directed at the primary tumor, potentially
leading to regional failures in otherwise curable patients. To increase the effectiveness of
SBRT for lung tumors, the next logical step is to explore whether the highest risk areas of
disease spread can be identified and targeted. Regional failure could be reduced and outcome
improved in a significant proportion of patients treated with SBRT if the primary nodal
drainage (PND) were identified, targeted and treated in addition to the primary tumor.
We propose to conduct a study to determine the feasibility of visualizing, by computed
tomography (CT) scans, water-soluble iodinated contrast materials after direct injection into
the tumor. Integration into radiation therapy treatment planning may also be assessed.
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