Dose-painting Radiation for LA-NSCLC (DPRLC)
Non-small Cell Lung Cancer Stage III, Non-small Cell Lung Cancer Stage II

About this trial
This is an interventional treatment trial for Non-small Cell Lung Cancer Stage III focused on measuring radiotherapy, dose-painting radiation, non-small cell lung cancer
Eligibility Criteria
Inclusion Criteria:
- The patient or the legal representative of the patient can sign a written informed consent, and can understand and agree to follow the research requirements;
- The age at the time of signing the informed consent form is between 18 and 75 years old;
- It is diagnosed as non-small cell lung cancer by histology, and is suitable for radical radiotherapy:
- Stage II-Ⅲ (AJCC 8th edition [Rice et al., 2017]) inoperable NSCLC patients (not medically suitable for surgery or refuse surgical intervention);
- Measurable lesions that meet the definition of RECISTv1.1;
- ECOG physical status ≤ 2;
- Survival expectancy ≥ 3 months;
- Hemoglobin ≥100g/L, WBC≥4×109/L, platelet ≥100×109/L (or follow the standards of each center);
- Liver function: ALT, AST<1.5 times the upper limit of normal (ULN), total bilirubin<1.5×ULN;
- Renal function: serum creatinine <1.5×ULN;
- Pulmonary function: FEV1>50%, the percentage of DLCO (lung diffusion function) measured value and predicted value>80% mild to moderate lung function impairment.
- The patient has good compliance with the treatment and follow-up.
Exclusion Criteria:
- There is evidence of distant metastasis (M1, AJCC 8th edition [Rice et al., 2017]);
- There is pleural effusion, pericardial effusion or ascites that is not clinically controlled and requires repeated drainage or medical intervention (within 2 weeks before randomization);
- Intolerance or resistance to the chemotherapy, targeted, and immunotherapy specified in the experimental protocol;
- Have received radiotherapy and surgical treatment;
- There were other active malignant tumors ≤ 2 years before enrollment, except for the specific cancers under study in this study and locally recurring cancers that have been cured (eg, resected basal cell or squamous cell skin cancer, superficial Bladder cancer, carcinoma in situ of the cervix or breast);
- A history of interstitial lung disease, non-infectious pneumonia or uncontrolled systemic diseases, including pulmonary fibrosis, acute lung diseases, etc.;
- Has suffered from other malignant tumors;
- Subjects who have received other drug trials within the past month;
- Pregnant or lactating women and women who refuse contraception during the treatment observation period;
- People with a history of severe allergies or idiosyncratic physique;
- Those with a history of severe lung or heart disease;
- Refusal or inability to sign the informed consent to participate in the trial;
- Drug or alcohol addicts;
- Personality or mental illness, lack of capacity for civil conduct or limited capacity for civil conduct.
Sites / Locations
- Sichuan Cancer Hospital & InstituteRecruiting
- Yunnan Cancer HospitalRecruiting
- Chongqing university three Gorges hospitalRecruiting
- General Hospital of Ningxia Medical UniversityRecruiting
Arms of the Study
Arm 1
Experimental
Assigned Interventions
Radiation therapy: Dose-painting radiation Systemic treatment: Choose a systemic treatment plan according to the patient's genetic testing status (1) Chemotherapy Squamous cell carcinoma: Paclitaxel 135mg/m2 D1 + Cisplatin 25mg/m2 D1-3, every 21 days, a total of 2-4 cycles. Non-squamous cell carcinoma (adenocarcinoma, large cell carcinoma): Pemetrexed 500mg/m2 d1 + Cisplatin 75 mg/m2 d1-3, a total of 2-4 cycles. (2) Targeted therapy: According to the patient's genetic testing status, molecular targeted therapy such as EGFR-TKI and ALK inhibitors can be selected; (3) Immunotherapy: According to the patient's genetic testing status, immunotherapy such as PD1/PD-L1 inhibitors can be selected;