Optimization of Treatment of Advanced Nonsmall Cell Lung Cancer Using Radiotherapy and Chemotherapy
Non Small Cell Lung Cancer

About this trial
This is an interventional treatment trial for Non Small Cell Lung Cancer focused on measuring lung cancer, nonsmall cell lung cancer, radiation therapy, chemotherapy, Locally advanced and metastatic nonsmall cell lung cancer
Eligibility Criteria
Study A Inclusion Criteria:
- Histologically or cytologically confirmed NSCLC
- Stage IIIA/IIIB staged with
- CT chest and upper abdomen
- Liver, renal, hematological reserve appropriate (according to "standard" institutional values)
- Brain CT and/or bone scan only if clinical symptoms request such investigation
- Performance status KPS 60-90
- No second cancer except skin non-melanoma
- No previous treatment
- Patient must be contactable for follow-up
- Patient to be able to start treatment within 2 weeks from randomization (institutional confirmation needed)
- Life expectancy > 3 months
- Patient must be able and willing to give informed consent, and fill in questionnaires
Study A Exclusion Criteria:
- Stage III B "wet" (existing pleural effusion , but not necessarily cytologically verified)
- RT field > 200 cm2
- Pregnancy
Study B Inclusion Criteria:
- KPS 60-90
- Stage IV and Stage III B (existing pleural effusions , but not necessarily cytologically verified)
- Histologically or cytologically confirmed
- CT staged disease (thorax and possible upper abdomen)
- No second cancer except skin non-melanoma
- Liver, renal, haematological reserve appropriate (according to "standard" institutional values)
- No previous treatment
- Patient must be contactable for follow-up
- Patient must be able and willing to give informed consent and fill in questionnaires
- Patient to be able to start treatment within 2 weeks from randomization (institutional confirmation needed)
- Life expectancy > 3 months
Study B Exclusion Criteria:
- Brain metastasis (brain CT and/or MRI not needed, unless symptoms exist - clinically indicated)
- RT field > 200 cm2
- Pregnancy
- A-P separation too large to be adequately treated with 60-Co (?)
Sites / Locations
- Instituto de Radiomedicine
- Affiliated Hospital of Ning Xia Medical College, Department of Radiation Oncology
- University of Zagreb Faculty of Medicine
- Misr Oncology Center (MOC)
- Tata Memorial Centre (TMC) Department of Atomic Energy (DAE)
- General Hospital Kuala Lumpur, Institute of Radiotherapy and Oncology
- Sir Paul Boffa Hospital
- Ministère de la Santé, Institut National d'Oncologie Sidi Mohamed Ben Abdellah
- Nuclear Medicine Oncology and Radiotherapy Institute
- Instituto Oncológico National
- Instituto Nacional de Enfermadades Neoplasicas Depto. De Radioterapia
- University of Witwatersrand Johannesburg Hospital Dept of Radiation Oncology
- Institut de la Sante Publique, Institut National de Cancer Salah Azaiz
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Active Comparator
Experimental
Active Comparator
Experimental
Radiotherapy
Chemotherapy and radiotherapy
Chemotherapy
Palliative radiotherapy and chemotherapy
For patients in Group A (Stage IIIA or IIIB), EBRT 39 Gy in 13 daily fractions over, with no chemotherapy.
For patients in Group A (either stage IIIA or IIIB) receive a course of up to 3 cycles of chemotherapy followed by EBRT of 10 Gy in a single fraction or 16 Gy in 2 fractions 1 week apart.
For patients in Group B (either stage IIIB (wet) or IV) receive up to 3 cycles of chemotherapy, and no radiotherapy.
For patients in Group B (either stage IIIB (wet) or IV) receive EBRT of 10 Gy in a single fraction or 16 Gy in two fractions 1 week apart, followed by up to 3 cycles of chemotherapy.