A trial of different doses of radiotherapy with chemotherapy for non small cell lung cancer (IDEAL-CRT)

You can enter this trial if you

• Have been diagnosed with non small cell lung cancer that is stage 2 or 3
• Have chosen not to have surgery to remove your cancer, or the lung cancer multi disciplinary team thinks you cannot have surgery, or that chemoradiation is a suitable treatment option for you
• Are well enough to carry out all your normal activities, apart from heavy physical work (performance status of 0 or 1)
• Have satisfactory results from blood tests and breathing tests (lung function tests)
• Are at least 18 years old
• Are willing to use reliable contraception during the trial and for a year afterwards if there is any chance you could become pregnant

You cannot enter this trial if you

• Have already had surgery to remove all or part of a lung (pneumonectomy or lobectomy)
• Have already had radiotherapy to your chest
• Have already had chemotherapy
• Have a tumour at the top of your lung so that a group of nerves called the brachial plexus would be within the area of radiotherapy
• Have either a lobe of a lung, or a whole lung that has collapsed
• Have had another cancer, apart from carcinoma in situ of the cervix, non melanoma skin cancer or any other cancer that has not caused symptoms or needed treatment in the last 3 years
• Have another serious medical condition such as long term liver or kidney disease, heart disease, high blood pressure that cannot be controlled with medication or an infection, or if the trial doctor thinks there is too high a risk of complications for you
• Are pregnant or breastfeeding

Everybody taking part in this trial will have radiotherapy and chemotherapy. You have radiotherapy every day from Monday to Friday for 6 weeks.  On the 1st or 2nd day of radiotherapy, you have vinorelbine and cisplatin through a drip into a vein. You have some extra fluid through the drip before and after the chemotherapy drugs. So the treatment takes about 6 or 7 hours all together. A week later, you have vinorelbine alone which only takes a few minutes. You have chemotherapy in the same way again starting on the 29th or 30th day of your radiotherapy.

You will see the doctors and have some tests before you start treatment. The tests include

• Physical examination
• Blood tests
• CT scan, PET scan or PET-CT scan
• Chest X-ray
• Tests to see how well your lungs are working (lung function tests)
• Heart trace (ECG)

You go to the radiotherapy department at the hospital twice to have your radiotherapy planned. Then you go to hospital every day from Monday to Friday for 6 weeks to have your radiotherapy. You will be at the hospital for longer on the 4 days that you have chemotherapy.

You see the trial doctor at least once a week during treatment. And you have a blood test before each chemotherapy treatment.

After you finish radiotherapy, you see the trial doctors

• Once a week for the first month
• Once a month for the next 5 months, then
• Every 3 months until 2 years after treatment
• Every 6 months in the following year
• Once a year after that

You have chest X-rays after 1 month, 3 months, 1 year, 18 months and 2 years. And CT scans after 3 months, 6 months, 1 year and 2 years.

The side effects of having chemotherapy and radiotherapy for lung cancer include

• Soreness when swallowing
• Tiredness (fatigue)
• Red skin in the treatment area
• Pain or discomfort in the chest
• Cough
• Breathlessness
• Inflammation of the lung (pneumonitis)

Very rarely, radiotherapy can cause damage to the spinal cord. If this happens, it can cause weakness or loss of sensation in your legs.

There is more information about the side effects of chest radiotherapy, cisplatin and vinorelbine on CancerHelp UK.