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

Cancer type:

Lung cancer

Non small cell lung cancer

Status:

Results

Phase:

Phase 1/2

This trial looked at giving a higher dose of radiotherapy with chemotherapy over a shorter period of time to people with non small cell lung cancer. Giving radiotherapy and chemotherapy together is called chemoradiation. Open a glossary item

Cancer Research UK supported this trial.

More about this trial

Cisplatin and vinorelbine are the 2 chemotherapy drugs most often used for chemoradiation. You usually have radiotherapy as daily treatments over about 6 and a half weeks.

Research has shown that a higher dose of radiotherapy works better. But it causes more side effects. Researchers wanted to learn more about giving a higher dose over a shorter period of time.

In this trial everybody had cisplatin and vinorelbine. But the doctors worked out the dose of radiotherapy on an individual basis. To do this they looked at what other healthy tissue or organs such as the food pipe (oesophagus) the radiotherapy could affect.

In this study people had radiotherapy over 6 weeks instead of 6 and a half.

The aim of the trial was to see if it was possible to work out the highest safe dose of radiotherapy on an individual basis. The researchers then wanted to see if they could look at this in a larger trial.

Summary of results

The trial team found the highest safe dose of radiotherapy to give for non small cell lung cancer (NSCLC).

84 people joined this phase 1/2 trial. Everyone had chemoradiation. Their radiotherapy was given over 6 weeks.

35 people took part in the phase 1 part of the trial.

This looked at the highest safe dose of radiotherapy to give people where the food pipe (oesophagus) would be affected.

The first people who joined had a certain dose of radiotherapy. The next people got a higher dose of radiotherapy if the food pipe of the first people wasn’t affected too much. And so on until they found the highest safe dose of radiotherapy.

The dose of radiotherapy for the other 49 people was worked out according to what other healthy tissue would be affected by the radiotherapy.

For the phase 2 part of the trial the researchers looked at the results of all 84 people.

After an average follow up of 35 months the team looked at the percentage of people who had no sign of their cancer a year and 2 years after radiotherapy.

They found it was:

72.0% of people at year 1
48.5% of people at year 2

They also looked at the percentage of people who were alive a year and 2 years after radiotherapy. They found it was:

87.8% of people at year 1
68% of people at year 2

The average length of time people lived after radiotherapy was just over 3 years.

The most severe side effects were:

inflammation of the food pipe (oesophagitis)
inflammation of the lung (pneumonitis)
a drop in white blood cells
lung infection

Radiotherapy doses are measured in a unit called a gray Open a glossary item (Gy). The trial team concluded that 68Gy is highest safe dose of radiotherapy for NSCLC where the oesophagus might also be affected.

The team have completed recruitment to an extension of the trial using the same sort of radiotherapy and chemotherapy over 5 rather than 6 weeks of treatment. This summary will be updated when those results become available.

We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item ) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.