Dose-escalated Adaptive Radiotherapy of Thoracic Disease for Small Cell Lung Cancer

Participation Requirements

• Sex:

  ALL

• Eligible Ages:

  18 and up

Participation Criteria

Inclusion Criteria:

* Minimum 18 years of age
* Biopsy proven, newly diagnosed, untreated SCLC
* Completed standard of care staging investigations including: CT chest/abdomen/pelvis, bone scan and/or or PET-CT scan, CT head or MRI brain, or chest X-ray
* Eligible for platinum doublet chemotherapy
* Eligible for thoracic radiotherapy, which can also include ipsilateral supraclavicular lymph node disease
* Capable of providing written, informed consent prior to participation in the study. Patient's legally authorized representative (LAR) may sign on behalf of the patient.
* Able and willing to comply with protocol rules and follow-up regimen
* Performance status of ECOG 0-2
* Pulmonary function tests showing FEV-1 \>1.0L and DLCO \> 50% predicted
* Radiation-targetable intrathoracic disease

Exclusion Criteria:

* No intrathoracic disease seen to target with radiation
* Thoracic disease is contiguous to extra-thoracic sites, beyond ipsilateral supraclavicular lymph nodes
* Mixed histology disease
* Active serious infection requiring therapy
* Brain metastasis that has not been symptomatically stable on dexamethasone
* 4 or more sites of extrathoracic disease, even if 2 or more of these are present in the same organ system
* Previous CNS or thoracic radiotherapy
* Previous chemotherapy
* Ineligibility for platinum doublet chemotherapy
* Life expectancy of less than 3 months
* Prior thoracic surgery
* History of another primary malignancy other than cutaneous basal cell carcinoma unless disease-free for at least 5 years
* Pregnant or breast-feeding
* In LS-SCLC, patients that are not eligible for concurrent chemoradiotherapy
* In ES-SCLC, patients that are not eligible for concurrent chemoradiotherapy under the experimental arm
* CT contrast allergy or kidney disease with irreversibly low creatinine clearance inadequate for IV contrast administration (for the purposes of high quality contrast enhanced CT chest and abdomen for follow-up imaging)
* Lack of intrathoracic disease or intrathoracic disease spread not feasible to treat with adaptive radiotherapy
* Participant in development and conduct of the research study