Predictors of Radiation Pneumonitis in Locally Advanced Lung Cancer Treated With Chemoradiation

NCT ID: NCT01580579

Last Updated: 2017-03-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

62 participants

Study Classification

OBSERVATIONAL

Study Start Date

2012-07-31

Study Completion Date

2016-01-31

Brief Summary

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Lung cancer \[LC\] is the leading cause of cancer death worldwide. The standard treatment of locally advanced lung cancer unresectable or marginally resectable is combination therapy with radical or preoperative chemoradiation. The local control rates and survival with this treatment modality have increased by more than 30%. Radiotherapy \[RT\] with technical molded 3D \[3D-CRT, Three-Dimensional Conformal Radiation Therapy\] or IMRT \[intensity-modulated radiation therapy\] has allowed that the total dose of radiation has increased which leads to a direct benefit on the results treatment.

Between 17-30% of patients are susceptible to pneumonitis due to radiation \[NR\]. This complication may appear at the end of the RT or up to 6 months after the treatment. In severe cases, mortality can reach 50%.

It's well known that in various diseases, functional abnormalities precede the clinical manifestations. The degree of pulmonary failure secondary to RT is measured following the standards of the Radiation Therapy Oncology Group who ranks in degrees \[0 to 4\].

Not precisely known factors that influence the development of NR.

Detailed Description

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Objectives:

To evaluate the effect of chemotherapy and thoracic radiotherapy on pulmonary function and identify predictors of radiation pneumonitis in locally advanced lung cancer \[stages IIIA and IIIB\].

Hypothesis:

Respiratory function tests may predict the development of radiation pneumonitis in patients with locally advanced lung cancer who receive radical treatment with chemoradiation.

Methods Prospective cohort study with patients with locally advanced lung cancer of the Lung Cancer Clinic of the National Cancer Institute \[INCAN\]. Patients will receive weekly paclitaxel 50 mg and carboplatin AUC 2 with concomitant radiotherapy 44-63 Gy (22-33 fractions). Followup of lung function tests at baseline, during treatment with radiotherapy and will be carried out on 4 more occasions.

Conditions

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Radiation; Adverse Effect, Pneumonitis

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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locally advanced lung cancer

Patients with locally advanced lung cancer who are candidates to chemoradiation

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Candidates must have understood and signed informed consent
* Histopathological diagnosis of locally advanced lung cancer \[IIIA-cT2N1-2, cT3N1-2, cT4N0, M0o IIIB: cT2N3, cT3N3, cT4N1-3, M0\]. They may also include patients with oligometastatic disease\[M1\] candidates for chemoradiation
* Any histology
* Medical tests: white blood cell count ≥ plasma 3,000 / mm3, platelets ≥ 100,000 / mm 3, hemoglobin ≥ 12 g / dl, serum creatinine ≤ 1.5 mg / dl, total bilirubin ≤ 1.5, transaminases \[ ≤ 2.5 times the upper limit of normal \[ULN\], alkaline phosphatase \<5 ULN.
* Age ≥ 18 years.
* General condition score according to ECOG 0 to 2 or a ≥ 60% Karnofsky.
* Estimated life expectancy with treatment of at least 24 weeks.

Exclusion Criteria

* Uncontrolled concurrent diseases.
* History of previous radiotherapy to the primary site.
* Pregnant or breast-feeding.
* Use of anticoagulants in therapeutic doses
* Intercurrent Malignancies, except dormant basal cell carcinoma in skin, carcinoma in situ of the cervix
* Invasive cancer unless the background was at least 5 years and the disease-free status.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Council of Science and Technology, Mexico

OTHER

Sponsor Role collaborator

Instituto Nacional de Cancerologia de Mexico

OTHER

Sponsor Role lead

Responsible Party

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Oscar Gerardo Arrieta Rodríguez MD

Chief of Thoracic Oncology Department

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Oscar Arrieta, MD

Role: PRINCIPAL_INVESTIGATOR

Instituto de Cancerología

Locations

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Instituto Nacional de Cancerología de México

Mexico City, Mexico City, Mexico

Site Status

Countries

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Mexico

References

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Kim M, Lee J, Ha B, Lee R, Lee KJ, Suh HS. Factors predicting radiation pneumonitis in locally advanced non-small cell lung cancer. Radiat Oncol J. 2011 Sep;29(3):181-90. doi: 10.3857/roj.2011.29.3.181. Epub 2011 Sep 30.

Reference Type BACKGROUND
PMID: 22984669 (View on PubMed)

Noble PW, Barkauskas CE, Jiang D. Pulmonary fibrosis: patterns and perpetrators. J Clin Invest. 2012 Aug;122(8):2756-62. doi: 10.1172/JCI60323. Epub 2012 Aug 1.

Reference Type BACKGROUND
PMID: 22850886 (View on PubMed)

Kong FM, Hayman JA, Griffith KA, Kalemkerian GP, Arenberg D, Lyons S, Turrisi A, Lichter A, Fraass B, Eisbruch A, Lawrence TS, Ten Haken RK. Final toxicity results of a radiation-dose escalation study in patients with non-small-cell lung cancer (NSCLC): predictors for radiation pneumonitis and fibrosis. Int J Radiat Oncol Biol Phys. 2006 Jul 15;65(4):1075-86. doi: 10.1016/j.ijrobp.2006.01.051. Epub 2006 May 2.

Reference Type BACKGROUND
PMID: 16647222 (View on PubMed)

Torre-Bouscoulet L, Arroyo-Hernandez M, Martinez-Briseno D, Munoz-Montano WR, Gochicoa-Rangel L, Bacon-Fonseca L, Perez-Padilla R, Vergara E, Garcia-Sancho C, Lozano-Ruiz F, Fernandez-Plata R, Guzman-Barragan A, Arrieta O. Longitudinal Evaluation of Lung Function in Patients With Advanced Non-Small Cell Lung Cancer Treated With Concurrent Chemoradiation Therapy. Int J Radiat Oncol Biol Phys. 2018 Jul 15;101(4):910-918. doi: 10.1016/j.ijrobp.2018.04.014. Epub 2018 Apr 12.

Reference Type DERIVED
PMID: 29976503 (View on PubMed)

Torre-Bouscoulet L, Munoz-Montano WR, Martinez-Briseno D, Lozano-Ruiz FJ, Fernandez-Plata R, Beck-Magana JA, Garcia-Sancho C, Guzman-Barragan A, Vergara E, Blake-Cerda M, Gochicoa-Rangel L, Maldonado F, Arroyo-Hernandez M, Arrieta O. Abnormal pulmonary function tests predict the development of radiation-induced pneumonitis in advanced non-small cell lung Cancer. Respir Res. 2018 Apr 24;19(1):72. doi: 10.1186/s12931-018-0775-2.

Reference Type DERIVED
PMID: 29690880 (View on PubMed)

Other Identifiers

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INCANOGAR2012-JA2

Identifier Type: -

Identifier Source: org_study_id

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