Advocate Health Care and Aurora Health Care researchers are studying the effects of using a specialized form of ultra-high-dose radiation therapy to treat lung cancer that cannot be removed with surgery.
“As part of a clinical trial, we want to see if adding stereotactic body radiation therapy (SBRT) to the current standard of care can help increase the chances of curing patients with advanced stages of lung cancer,” said radiation oncologist Jeffrey Kittel, MD, Advocate Aurora Research Institute’s principal investigator for the study. “With SBRT, we can use specialized equipment to deliver a much larger dose of radiation to the tumor with extreme precision. As a result, SBRT is very effective and very low-risk. It is commonly used to treat early stages of lung cancer that are confined to the lung. This trial is testing whether we can apply the technique of SBRT to cancer that is more advanced and has already spread to the lymph nodes.”
Lung cancer is the leading cause of cancer death and the second most common cancer in the U.S., according to the Centers for Disease Control and Prevention. Non-small cell lung cancer is the more common of the two main types of lung cancer and is often associated with a history of smoking.
For people with inoperable non-small cell lung cancer, the standard treatment is conventional radiation therapy plus chemotherapy, followed by immunotherapy. Conventional radiation is typically delivered to both the primary tumor as well as to any lymph nodes that are involved. However, many patients treated with conventional chemoradiation will have recurrence of their primary tumor.
For this clinical trial, half of the participants will be randomly assigned to instead receive SBRT to the site of the primary tumor and then conventional radiation to the lymph nodes.
With SBRT, doctors can focus many small beams of radiation from different directions to deliver a concentrated dose of radiation that is highly precise and spares surrounding healthy tissue from the toxic side effects of radiation. It has significantly increased the chance of being cured of early stage lung cancer compared to using conventional radiation.
However, doctors have not routinely used SBRT to treat inoperable non-small cell lung cancer that has spread to lymph nodes due to the risks of delivering high doses of radiation to those areas.
“SBRT is very safe and effective when tumors are in the lung but is known to have a higher risk of side-effects when treating close to the sensitive airways and blood vessels around the lymph nodes,” Dr. Kittel said. “This trial aims to get the best of both worlds – using SBRT to treat the primary tumor in the lung and using conventional chemoradiation to safely treat the lymph nodes.”
“In addition to evaluating how well SBRT slows the progression of the cancer, researchers aim to determine whether eliminating conventional radiation to the primary tumor site results in less harm to a person’s lung function and a greater preservation in quality of life,” said Melissa Kadar, Director of the Research Institute’s Center of Excellence in Cancer Research.
The clinical trial, which is open at Advocate and Aurora cancer clinics in communities across Illinois and Wisconsin, will enroll nearly 500 participants at sites throughout the country.
The Research Institute is participating in the study through its inclusion in the National Cancer Institute’s (NCI) Community Oncology Research Program (NCORP), which brings cancer clinical trials to people in their own communities instead of only at major research institutions.
The clinical trial, “NRG-LU008: Phase III Prospective Randomized Trial of Primary Lung Tumor Stereotactic Body Radiation Therapy Followed by Concurrent Mediastinal Chemoradiation for Locally-Advanced Non-Small Cell Lung Cancer,” is managed by NRG Oncology, a cooperative research group that designs and conducts clinical trials under the sponsorship of NCI.
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