Stereotactic Radiation Therapy for Centrally and Ultra-centrally Located Lung Tumors STRICT-LUNG & STAR-LUNG Study
Led by Rigshospitalet, Denmark · Updated on 2023-03-03
138
Participants Needed
6
Research Sites
382 weeks
Total Duration
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R
Rigshospitalet, Denmark
Lead Sponsor
A
Aarhus University Hospital
Collaborating Sponsor
AI-Summary
What this Trial Is About
Researchers are evaluating the safety, feasibility, and effectiveness of stereotactic body radiation therapy (SBRT) in treating centrally and ultra-centrally located lung tumors. The study involves patients with primary, oligo-metastatic, or oligo-progressive non-hematological cancers, focusing on tumor control, treatment-related side effects, quality of life, and survival outcomes. It aims to improve understanding and future treatment strategies for these challenging tumor locations.
Patients with centrally located lung tumors receive SBRT using standard linear accelerators with daily cone beam CT image-guidance and plan adaptation, while those with ultra-centrally located tumors are treated on MR-linac machines with daily MR-guided plan adaptation. Central tumors are defined by proximity to specific airways and organs, and ultra-central tumors are even closer to critical structures. Tumor location and suitability are assessed by diagnostic imaging, and treatment plans are adapted daily to target tumors precisely.
Participants will be monitored extensively, with treatment-related adverse events recorded from baseline through up to 10 years post-treatment at multiple intervals. Follow-up includes imaging scans and clinical assessments to measure tumor control, disease progression, and survival. Quality of life is also assessed. The study enrollment continues until target patient numbers are met, allowing detailed long-term evaluation of treatment outcomes and safety for both tumor groups.
CONDITIONS
Brief Title
A Multicenter Phase II Study of Stereotactic Radiotherapy for Centrally Located Lung Tumors (STRICT-LUNG STUDY) and Ultra-centrally Located Lung Tumors (STAR-LUNG STUDY).
Who Can Participate
Age: 18Years +
All Genders
Eligibility Criteria
You may qualify if you...
Histology or cytology proven non-hematological cancer or known cancer with local progressive recurrence.
ECOG performance status 2 or less.
Age over 18 years.
Life expectancy greater than 6 months.
Maximum one central tumor with diameter 5 cm or less, or multiple adjacent tumors with a combined diameter up to 5 cm on diagnostic CT.
Medically inoperable or refused surgery.
Central tumors located within or touching 2.5 cm zone of PBT, or within 0.5 cm from spinal cord, esophagus, or heart.
All metastatic sites treated or planned for ablative therapy; for oligo-progressive disease only progressing sites must meet this.
Adequate lung function to tolerate treatment as decided by treating physician.
Ability to understand and willingness to sign informed consent.
Patient accessible to treatment and follow-up procedures.
Fertile women must have negative pregnancy test.
Fertile men and women must use effective contraception during treatment and one month thereafter.
Ultra-centrally located tumors within 0.0 to 0.5 cm of trachea, main bronchi, or intermediate bronchus.
Patients with other non-central tumors synchronous with central lesion may be included and treated per local practice.
Baseline PET/CT scan within 2 months of inclusion.
Ablative strategy deemed clinically relevant by treating physician.
You will not qualify if you...
Tumor with intra-bronchial or intra-tracheal growth as seen on imaging or endoscopy.
Previous radiotherapy with combined dose at site exceeding dose constraints as judged by treating physician.
Patient unable to tolerate physical setup required for SBRT.
Uncontrolled intercurrent illness.
Pregnancy.
Participation in another interventional study.
For ultra-centrally located tumor patients, lack of MR compatibility due to pacemaker, steel implants, or similar.
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Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Treatment
Duration - Daily treatment sessions over a short period as determined by clinical protocol
Participants receive stereotactic body radiation therapy targeting centrally or ultra-centrally located lung tumors with daily image-guided plan adaptation.
Daily visits for treatment sessions
Follow-up
Duration - Up to 10 years
Participants are monitored for treatment-related adverse events, quality of life, tumor control, and survival outcomes for up to 10 years after treatment.
Regular visits at treatment end, 4-6 weeks, 3, 6, 9, 12, 15, 18, 21, 24, 30, 36, 42, 48, 54, 60 months, and annually up to 10 years
Thorough design and pre-trial quality assurance (QA) decrease dosimetric impact of delineation and dose planning variability in the STRICTLUNG and STARLUNG trials for stereotactic body radiotherapy (SBRT) of central and ultra-central lung tumours.