Esophageal Sparing Intensity-modulated Radiation Therapy (IMRT) for Locally-Advanced Thoracic Malignancies (ESIMRT)
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Purpose
Hypothesis 1- Using IMRT, the radiation therapy (RT) dose can be safely escalated from 58 Gy to 74 Gy given as 6 fractions/week with concurrent chemotherapy.
Hypothesis 2- Esophageal motion can be used to customize planning organ at risk volumes.
Hypothesis 3- Biological predictors of acute esophagitis can be used to identify patients at high risk of developing esophageal toxicity from radiation therapy and chemotherapy.
| Condition | Intervention | Phase |
|---|---|---|
|
Non Small Cell Lung Cancer Small Cell Lung Cancer Thymoma Thymus Neoplasms |
Radiation: Esophageal sparing IMRT |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Phase I Dose Escalation Study of Accelerated Fractionation With Esophageal Sparing Using Intensity-Modulated Radiation Therapy for Locally-Advanced Thoracic Malignancies Including a Prospective Assessment of Esophageal Motion and Radiation-Induced Esophageal Injury |
- Maximum tolerated dose (MTD) of IMRT [ Time Frame: within 30 days of completing RT ] [ Designated as safety issue: Yes ]
- The occurrence of RT-induced acute esophagitis [ Time Frame: One year ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 25 |
| Study Start Date: | August 2009 |
| Estimated Study Completion Date: | April 2015 |
| Estimated Primary Completion Date: | August 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: IMRT concurrent with chemotherapy
6 fractions of esophageal sparing IMRT weekly for 5-6 weeks (dependent on dose cohort) concurrent with standard chemotherapy: Cisplatin 50 mg/m2 /d intravenously (IV) on days 1, 8, 29, and 36. Etoposide 50 mg/m2 /d IV on days 1 through 5 and 29 through 33.
|
Radiation: Esophageal sparing IMRT
6 fractions/week of 2Gy each for 29 fx (58 Gy), 31 fx (62 Gy), 33 fx (66 Gy), 35 fx (70 Gy), or 37 fx (74 Gy).
|
Detailed Description:
Prospective phase I study designed to determine the maximum tolerated dose of radiation therapy given in an accelerated fashion (2 Gy/fraction, 6 fractions/week) with concurrent chemotherapy. Intensity-modulated radiation therapy (IMRT) will be utilized to spare the esophagus. All patients on the dose escalation study will participate in additional assessments evaluating esophageal motion and esophageal toxicity from radiation therapy.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Histologic documentation of one of the following thoracic malignancies:
- Non-small cell lung cancer (stage III or X (recurrent) with disease confined to local/regional sites)
- Small cell lung cancer (stage II-III)
- Thymoma (unresectable)
- Thymic carcinoma (unresectable)
- Eastern Cooperative Oncology Group (ECOG) performance status 0-1
- Weight loss < 10% in preceding 3 months prior to diagnosis
- ANC > or = 1500 and platelet count > or = 100,000.
- Creatinine clearance greater than 50 ml/min
- 18 years of age or older.
- Negative pregnancy test in women of child-bearing potential
Exclusion Criteria:
- Prior thoracic irradiation
- Medical contraindications to thoracic irradiation
Contacts and Locations| Contact: Christopher Kelsey, MD | 919 668-5213 | |
| Contact: Joan Cahill | 919 668-3726 | joan.cahill@duke.edu |
| United States, North Carolina | |
| Duke University Medical Center | Recruiting |
| Durham, North Carolina, United States, 27710 | |
| Contact: Christopher Kelsey, MD 919-668-5213 | |
| Principal Investigator: Christopher Kelsey, MD | |
| Sub-Investigator: Shiva Das, PhD | |
| Sub-Investigator: Frank R Dunphy, MD | |
| Principal Investigator: | Christopher Kelsey, MD | Duke University Medical Center, Dept Radiation Oncology |
More Information
Publications:
| Responsible Party: | Duke University |
| ClinicalTrials.gov Identifier: | NCT00921739 History of Changes |
| Other Study ID Numbers: | Pro00017361 |
| Study First Received: | June 15, 2009 |
| Last Updated: | May 1, 2013 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Duke University:
|
Non small cell lung cancer Small cell lung cancer Thymoma unresectable Thymic carcinoma unresectable |
Additional relevant MeSH terms:
|
Thymus Neoplasms Neoplasms Carcinoma, Non-Small-Cell Lung Esophageal Diseases Lung Neoplasms Thymoma Small Cell Lung Carcinoma Carcinoma, Bronchogenic Bronchial Neoplasms Respiratory Tract Neoplasms |
Thoracic Neoplasms Neoplasms by Site Lung Diseases Respiratory Tract Diseases Gastrointestinal Diseases Digestive System Diseases Neoplasms, Complex and Mixed Neoplasms by Histologic Type Lymphatic Diseases |
ClinicalTrials.gov processed this record on May 16, 2013