Quality of life analysis of a radiation doseescalation. May 16, 2016 nrg oncology rtog 6 a randomized phase ii study of individualized combined modality therapy for stage iii nonsmall cell lung cancer nsclc. Rtog 4 ulceration, bleeding, necrosis rarely seen rtog assessment tool and intervention rationales please can you ensure that all patients on discharge are given one weeks supply of the dressings they are on. Oncology quality control guidelines stated in the rtog procedures manual. Radiation dose in the setting of chemoradiation for locally advanced nonsmall cell lung cancer nsclc has been historically limited by the risk of normal tissue toxicity and this has been hypothesized to correlate with the poor results in regard to local tumor recurrences. We evaluated the impact of esophagealsparing imrt on cardiac doses with and without the heart considered in the planning process and. Dose escalation, as a means to improve local control, with concurrent chemotherapy has been shown to be feasible with. To compare the efficacy of moderateduration 28week neoadjuvant total androgen suppression and rt with shortduration 8week neoadjuvant total androgen. Radiation oncologyrtog trials wikibooks, open books for an. The intergrouprtog 8501 concurrent chemoradiation regimen for japanese esophageal cancer. Pdf esophagus and contralateral lungsparing imrt for. A promising result of locoregional tumor control with biologically. The efficacy of this qc tool was retrospectively evaluated using a subset of plans submitted to radiation therapy oncology group rtog study 0617.
Radiation oncologynsclclocally advanced unresectable. Nrgalias broadcasts rtog clinical trials protocol table. The initial results of rtog 0617 which ran domized patients with stages iiia or iiib. Frontiers strategies of dose escalation in the treatment. Pdf concurrent chemoradiation crt as the standard treatment for. It was sponsored by ncis radiation therapy oncology group rtog under study number rtog 0617. The rtog 0617 trial, just published online first in lancet oncology, echoes this same theme, this time clearly refuting a widespread presumption that a higher dose of chest radiation therapy. Rtog 0630 radiation therapy oncology group rtog 0630 a phase ii trial of image guided preoperative radiotherapy for primary soft tissue sarcomas of the extremity study chairs principal investigatorradiation oncology surgical oncology cochair dian wang, md, phd john m. The radiation therapy oncology group rtog 0617 trial did not. Apr 10, 2015 radiation therapy oncology group rtog 0617 was a study initially designed to address an important issue in radiation oncology regarding the treatment of stage iii nonsmall cell lung cancer nsclc. Although based on the lesson learned from rtog 0617, pbt allows for safe doseescalation, it is also well described that pbt, especially passively scattered pbt the technique utilized in the phase ii trial, clearly does not guarantee higher conformality than.
Heart and lung doses are independent predictors of overall. Finally, although this trial was not designed to test survival, the median overall survival time of 28. The evolving role of radiotherapy in nonsmall cell lung. The compliance criteria used for two earlier rtog trials rtog 0617 1 and rtog 1106 6were used to develop the compliance criteria for the rtog 8.
A randomized, phase iii, doubleblind, placebocontrolled trial of memantine for prevention of cognitive dysfunction in patients receiving wholebrain radiotherapy nadia n. Publications home of jama and the specialty journals of. Pelvic irradiation with concurrent chemotherapy versus pelvic. Impact of intensitymodulated radiation therapy technique. No other use or reproduction is authorized by rtog nor does rtog assume any. For example, in rtog 0617, a randomized phase iii trial comparing 60 to 74 gy with concurrent chemotherapy in the treatment of inoperable stage iii nsclc.
A phase iii study comparing combined external beam radiation and transperineal interstitial permanent brachytherapy with brachytherapy alone for selected patients with intermediate risk prostatic carcinoma. Prognosis of locally advanced nonsmall cell lung cancer remains poor despite chemoradiation. Nrg oncology radiation therapy oncology group rtog 0617 bree r. Nsclccetuximab the cancer imaging archive tcia public. Advanced radiation techniques for locally advanced nonsmall cell. Improved survival with doseescalated radiotherapy in stage iii non. Rtog 0617 found that overall survival was impacted by increased low 5 gy and intermediate 30 gy cardiac doses. Radiation dose escalation in stage iii nonsmallcell lung cancer.
Rtog 0617 locally advanced nsclc results at astro rtog. Radiation oncologytoxicityrtog wikibooks, open books for. Establishing the feasibility of the dosimetric compliance. Highdose radiation therapy does not improve overall survival for patients with locally advanced, nonsmall cell lung cancer. Clinical data which will allow users to compare the adverse events and treatments between arms in trialare located on the nctnncorp data archive. Previous work by delaney et al showed that inferior quality plans used to create kbp models produced predictions and kbps with inferior plan quality. Survival advantage for etoposidecisplatin over paclitaxel. Institutional enrollment and survival among nsclc patients. The radiation therapy oncology group rtog 0617 trial was. Kane iii, md medical college of wisconsin roswell park cancer institute. A shorter radiation therapy schedule can be as effective as a. Rtog 08 seamless phase iii study of stereotactic lung radiotherapy sbrt for early stage, centrally located nonsmall cell lung cancer nsclc in medically inoperable patients author fabead. Assessment observation effects of radiotherapy on skin cells rationale rtog 0 no visible. This is being used in the petboost trial, detailed in table 3.
Pdf the intergrouprtog 8501 concurrent chemoradiation. Radiation therapy oncology group rtog 0617 was a study initially designed to address an important issue in radiation oncology regarding the treatment of stage iii nonsmall cell lung cancer nsclc. Patients were randomly assigned to receive highdose 74 gy in 37 fractions or standard dose 60 gy in 30 fractions radiotherapy concurrently with weekly paclitaxel and carboplatin with or without cetuximab, followed. In the lancet oncology, jeffrey bradley and colleagues1 report a randomised controlled trial of chemoradiotherapy for patients with stage iii nonsmallcell lung cancer. A phase iii trial to evaluate the duration of neoadjuvant total androgen suppression tas and radiation therapy rt in intermediate risk prostate cancer objective. Lung cancer patients who receive intensity modulated. Radiation therapy oncology group protocol 0617 recently. For example, functional imaging information can be used to increase the rt dose to particular areas. One potential option is immunotherapy, which in metastatic nsclc has shown promise for sustained disease control in a subset of patients. For patients with stage iii nonsmallcell lung cancer with unresectable or inoperable tumors, definitive chemoradiotherapy is often utilized.
Rtog 0617 and heart contours patient prescription revised heart rtog heart difference l008 60 5. This study is a secondary analysis of the data compiled from nrg rtog 0617 to compare the use of imrt and 3d crt in patients with lung cancer. Rtog 0415 data indicates treatment delivered over five and onehalf weeks results in similar diseasefree survival rates as an eightweek schedule. Nrg rtog 0617 was a large, multiinstitutional phase iii, randomized clinical trial of patients with locallyadvanced nonsmall cell lung cancer nsclc conducted from 2007 to 2011. However, in the phase iii rtog 0617 study, dose escalation to 74 gy led to.
Radiation therapy oncology group rtog 0618 a phase ii trial of stereotactic body radiation therapy sbrt in the treatment of patients with operable stage iii nonsmall cell lung cancer study chairs 2409 principal investigatorradiation oncologyigrt robert d. Chemoradiotherapy of locally advanced esophageal cancer. The primary qol hypothesis predicted a clinically meaningful decline in quality of life. Comments on medscape are moderated and should be professional in tone and on topic.
Lung cancer remains the leading cause of cancer deaths in the united states us and worldwide. Radiation therapy alone r for all s egfr expression r rt, 2 gyday, in 30 fractions e patients. Group 0617, overall survival os was worse in the highdose arm. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. Sixtyfive institutions were credentialed with spine phantom dosimetry and igrt compliance. Limiting the risk of cardiac toxicity with esophageal. Esophagus and contralateral lungsparing imrt for locally advanced lung cancer in the community hospital setting.
This collection contains data from the national cancer insitute clinical trial nct00533949, highdose or standarddose radiation therapy and chemotherapy with or without cetuximab in treating patients with newly diagnosed stage iii nonsmall cell lung cancer that cannot be removed by surgery. Roughly half of patients in rtog 0617 were treated with doseescalated. Impact of unfavorable factors on outcomes among inoperable. Rtog 08 seamless phase iii study of stereotactic lung. Radiation oncologyrtog trials0117 wikibooks, open books. San antonio, october 19, 2015 hypofractionated radiation therapy rt, which is delivered in larger doses over a shorter time period than conventional rt, results in similar rates of cure and. Standarddose versus highdose conformal radiotherapy with. Patient characteristics for patients treated with standard rt or esophagus and contralateral lungsparing imrt. Rtog 0631 radiation therapy oncology group rtog 0631 phase iiiii study of imageguided radiosurgerysbrt for localized spine metastasis study chairs principal investigatorradiation oncology samuel ryu, md henry ford hospital 2799 w. This is an invited article commissioned by the section editor dr. It was sponsored by ncis radiation therapy oncology group rtog under study number rtog0617. Secondary analysis of nrg oncology rtog 0617 pmid 28034064, pmid 28068179 impact of intensitymodulated radiation therapy technique for locally advanced nonsmallcell lung cancer. Stereotactic body radiation therapy sbrt offers excellent local control of earlystage nonsmall cell lung cancer nsclc, but there currently is a need for tolerable systemic therapy to address regional and distant disease progression.
Rtog 0631 phase iiiii study of imageguided stereotactic. Results from rtog 0617, comparing conventionally fractionated 60 gy vs 74 gy with concurrent chemotherapy in patients with unresectable nonsmallcell lung cancer nsclc, informed us that uniform dose escalation over the entire tumor volume in. These results serve as projection expectations for the highdose radiation arms of the current rtog 0617 phase iii intergroup. In the highdose arm of rtog 0617, 3 of 206 patients died of. In rtog 0617, either imrt or threedimensional conformal radiotherapy was allowed. This study aimed to evaluate the feasibility of using a singleinstitution, knowledgebased planning kbp model as a dosimetric plan quality control qc for multiinstitutional clinical trials. Chang, md, phd md anderson cancer center md anderson cancer center 1515 holcombe blvd. Impact of intensitymodulated radiation therapy technique for locally advanced nonsmallcell lung cancer. Rtog 0617, a randomized phase iii cooperative group trial using 2 x 2 factorial design, with. Radiation therapy oncology group rtog 0618 a phase ii trial. In light of rtog 0617, use of pbt to doseescalate these patients remains controversial. Rtog is funded by national cancer institute grant numbers.
Radiation therapy oncology group rtog 9405 has demonstrated that higher. No other use or reproduction is authorized by rtog nor does rtog assume. It is intended to be used only in conjunction with institutionspecific irb approval for study entry. The median ptv volume, 399 cm 3, was approximately 10% to 20% smaller than the median ptv in rtog 0617 range, 429481, likely owing to the 1 to 1. The phase ii component of rtog 0631 assessed the feasibility and safety of spine radiosurgery srs for localized spine metastases in a cooperative group setting. Radiation oncologytoxicity gradingrtog wikibooks, open. Nrg oncology radiation therapy oncology group rtog 0617. Esophagus and contralateral lungsparing imrt for locally. The results of the radiation therapy oncology group rtog phase iii clinical trial were reported october 3, 2011 at the american society for radiation oncology astro annual meeting. The maximum achievable boost directed to radioresistant primary tumor subvolumes based on pretreatment fluorine18 fluorodeoxyglucose positron emission tomographycomputed.
Request pdf on mar 1, 2012, james d cox and others published are the results of rtog 0617 mysterious. Rtog 1016 phase iii trial of radiotherapy plus cetuximab. Historically, local control and overall survival rates have been poor. Heart dose is an independent dosimetric predictor of overall. Some society journals require you to create a personal profile, then activate your society account. Institutional enrollment and survival among nsclc patients receiving chemoradiation.
A recent randomized radiation doseescalation trial in unresectable stage iii nonsmallcell lung cancer nsclc radiation therapy oncology group rtog 0617 showed a lower survival rate in the highdose radiation therapy rt arm 74 gy than in the lowdose arm 60 gy with concurrent chemotherapy. Find, read and cite all the research you need on researchgate. Esophagus and contralateral lungsparing imrt for locally advanced lung cancer in the community hospital setting article pdf available in frontiers in oncology 5. Although rtog 0617 failed to demonstrate the benefit of dose escalation with conventional fractionation, a more individualized strategy deserves to be investigated.
Stage iii nonsmall cell lung cancer that cannot be removed by surgery. Advances in proton therapy in lung cancer melissa a. Nrg oncology rtog 6 a randomized phase ii study of. Standarddose versus highdose conformal radiotherapy with concurrent and consolidation carboplatin plus paclitaxel with or without cetuximab for patients with stage iiia or iiib nonsmallcell lung cancer rtog 0617. A secondary analysis of the nrg oncology rtog 0617 randomized clinical trial. Dosimetric compliance criteria for rtog 8 trial the total prescribed dose will be up to 70 gy rbe without exceeding the tolerance dosevolume limits of all critical normal structures. From wikibooks, open books for an open world pdf ongoing breast phase ii. The worlds most comprehensive professionally edited abbreviations and acronyms database all trademarksservice marks referenced on this site are properties of their respective owners. Combining stereotactic body radiation therapy with. Controversies in doseescalation for locally advanced nonsmall cell. Intensity modulated radiotherapy imrt is routinely utilized in the treatment of locally advanced nonsmall cell lung cancer nsclc. Rtog 0617ncctg n0628calgb 30609ecog r0617, a randomized phase. Laack, ms, md this trial was conducted by the radiation therapy oncology group rtog, and.
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