SPECT/CT in Measuring Lung Function in Patients With Cancer Undergoing Radiation Therapy

NCT ID: NCT01982123

Last Updated: 2018-12-13

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

12 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-01-17

Study Completion Date

2017-09-13

Brief Summary

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This pilot clinical trial studies single photon emission computed tomography (SPECT)/computed tomography (CT) in measuring lung function in patients with cancer undergoing radiation therapy. Diagnostic procedures that measure lung function may help doctors find healthy lung tissue and allow them to plan better treatment.

Detailed Description

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PRIMARY OBJECTIVES:

I. To utilize SPECT/CT imaging with technetium Tc-99m microaggregated albumin (99mTc-MAA) and 99mTc-diethylenetriamine pentaacetic acid (99mTc-DTPA) to identify functional lung on serial imaging in patients receiving radiation treatment to the thorax, as well as to characterize reproducibility of perfusion and ventilation in non-irradiated lung tissue.

SECONDARY OBJECTIVES:

I. To estimate the dose response relationship on multiple spatial scales (global lung, regional lung, lung image voxel) between radiation dose and changes in lung ventilation and perfusion, both acutely (mid-radiation treatment) and long term (3 months post-treatment), using SPECT/CT imaging with 99mTc-MAA and 99mTc-DTPA.

II. To estimate the degree of radiation response in lung tissue with varying levels of function (i.e. compare radiation dose response of well ventilated and well perfused tissue against lung tissue with poor perfusion and ventilation).

TERTIARY OBJECTIVES:

I. To evaluate proton radiation therapy for functional lung sparing in lung cancers and other cancer in the thorax through treatment planning comparisons to conventional photon radiation therapy.

II. To evaluate the feasibility of incorporating standard-of-care fludeoxyglucose F 18 (18F-FDG) positron emission tomography (PET) images into proton and photon radiotherapy planning for dose escalation to functionally viable regions of gross thoracic disease.

OUTLINE:

Patients undergo 99mTc-MAA and 99mTc-DTPA SPECT/CT at baseline, mid-radiation therapy (up to 1 week post-treatment), and at 3-6 months post-treatment. Patients also undergo a pre-treatment 18F FDG PET/CT scan per standard of care.

After completion of study, patients are followed up periodically.

Conditions

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Lung Carcinoma Malignant Neoplasm

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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SPECT/CT Mid-& Post-RT

Investigational 99mTc-MAA and 99mTc-DTPA SPECT/CT mid-radiation therapy (up to 1 week post-treatment), and at 3-6 months post-treatment.

Group Type EXPERIMENTAL

SPECT/CT

Intervention Type DIAGNOSTIC_TEST

Undergo 99mTc-MAA and 99mTc-DTPA SPECT/CT mid-radiation and post-radiation

Single Photon Emission Computed Tomography

Intervention Type PROCEDURE

Undergo 99mTc-MAA and 99mTc-DTPA SPECT/CT

Technetium Tc-99m Albumin Aggregated

Intervention Type RADIATION

Undergo 99mTc-MAA SPECT/CT

Technetium Tc-99m DTPA

Intervention Type DRUG

Undergo 99mTc-DTPA SPECT/CT

Interventions

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SPECT/CT

Undergo 99mTc-MAA and 99mTc-DTPA SPECT/CT mid-radiation and post-radiation

Intervention Type DIAGNOSTIC_TEST

Single Photon Emission Computed Tomography

Undergo 99mTc-MAA and 99mTc-DTPA SPECT/CT

Intervention Type PROCEDURE

Technetium Tc-99m Albumin Aggregated

Undergo 99mTc-MAA SPECT/CT

Intervention Type RADIATION

Technetium Tc-99m DTPA

Undergo 99mTc-DTPA SPECT/CT

Intervention Type DRUG

Other Intervention Names

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Medical Imaging, Single Photon Emission Computed Tomography Single Photon Emission Tomography single-photon emission computed tomography SPECT SPECT imaging SPECT SCAN SPET tomography, emission computed, single photon Tomography, Emission-Computed, Single-Photon Tc 99m-labeled MAA Technetium Tc 99m-Labeled Macroaggregated Albumin 99m-technetium Diethylenetriaminepentaacetic Acid Tc-99m-DTPA Tc-DTPA

Eligibility Criteria

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Inclusion Criteria

* Cancer patients receiving radiation treatment to the thorax to at least 45 Gy; patient must have pathologic confirmation of diagnosis, or have an enlarging lung mass on at least two scans spaced 3 months apart, and FDG avidity on PET scan
* Patients must be planned for at least 45 Gy of thoracic radiation
* Patients are not required to have measurable disease; post-operative patients (patients who have had surgical resection of the lung) are eligible
* Patients must have pulmonary function as defined below:

* Abnormal pulmonary function test within 3 months of study entry
* Prior radiation to the lungs
* Prior surgical resection of lung tissue (i.e. wedge resection, lobectomy, or pneumonectomy)
* Clinical diagnosis of chronic obstructive pulmonary disease (COPD) or emphysema
* Ongoing oxygen use
* There are no limits on prior therapy; patients are allowed to have prior chemotherapy, radiation therapy, and surgery; patients are allowed to have concurrent chemotherapy with radiation treatment; patients are allowed to have chemotherapy after radiation treatment; patients are not allowed to have planned lung resection after radiation
* Ability to understand and the willingness to sign a written informed consent document
* Patients will typically be enrolled on this trial prior to beginning the radiation treatment course; however, if a patient has had a SPECT/CT 99mTc-MAA and 99mTc-DTPA scan as part of routine medical care within 6 weeks prior to initiation of radiation treatment, he/she is eligible for trial enrollment up to the last day of the radiation treatment course

Exclusion Criteria

* Patients must not be planned for lung resection after radiation therapy
* Patients receiving \< 45 Gy radiation
* Patients who received radiation to the chest within the past 6 months
* Patients unable to tolerate a SPECT/CT 99mTc-MAA and 99mTc-DTPA scan
* Patients who are not planning to adhere to the required follow up schedule as outlined in this protocol
* Pregnant women
* Women of childbearing potential and men who are sexually active and not willing/able to use medically acceptable forms of contraception
* Patients unable to provide informed consent
Minimum Eligible Age

19 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

University of Washington

OTHER

Sponsor Role lead

Responsible Party

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Jing Zeng

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jing Zeng

Role: PRINCIPAL_INVESTIGATOR

Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium

Locations

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Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium

Seattle, Washington, United States

Site Status

ProCure Proton Therapy Center-Seattle

Seattle, Washington, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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NCI-2013-01774

Identifier Type: REGISTRY

Identifier Source: secondary_id

8180

Identifier Type: OTHER

Identifier Source: secondary_id

P30CA015704

Identifier Type: NIH

Identifier Source: secondary_id

View Link

8180

Identifier Type: -

Identifier Source: org_study_id