This clinical trial studies fludeoxyglucose F 18 (FDG) positron emission tomography (PET)/computed tomography (CT) in predicting chemoradiation therapy (CRT) failure in patients with stage IIIA non-small cell lung cancer (NSCLC). Diagnostic procedures, such as FDG PET/CT, may help predict CRT failure. Comparing diagnostic results during CRT may help doctors predict a patient's response to treatment and help plan the best treatment
PRIMARY OBJECTIVES: I. To determine whether early response of the research positron emission tomography (PET)-computed tomography(CT) scan measured by change in Standard Uptake Value (SUV)max relative to baseline scan can predict induction chemoradiation therapy (CRT) failures sooner than post-treatment PET-CT scan. II. To determine the optimal timing for 18FDG PET-CT that best predicts for induction CRT failure. SECONDARY OBJECTIVES: I. To correlate early 18 fludeoxyglucose (FDG) PET-CT response metrics with pathologic response, progression-free survival separately for: induction CRT failures vs. non-failures, or overall survival separately for induction CRT failures vs. non-failures. OUTLINE: Patients are randomized to 1 of 3 groups. Patients undergo a baseline FDG PET/CT scan and receive standard radiotherapy (RT) for 28 fractions with concurrent chemotherapy. GROUP A: Patients undergo a FDG PET/CT scan between RT fractions 5-6 (before course 2 of chemotherapy). GROUP B: Patients undergo a FDG PET/CT scan between RT fractions 10-11 (before course 3 of chemotherapy). GROUP C: Patients undergo a FDG PET/CT scan between RT fractions 15-16 (before course 4 of chemotherapy). Approximately 6 weeks after completion of CRT, patients undergo a FDG PET/CT scan and undergo standard tumor resection. After completion of study treatment, patients are followed up every 3 months for 2 years and then every 6 months thereafter.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
NONE
Undergo FDG PET/CT
Undergo FDG PET/CT
Induction therapy failure
Defined as any evidence by clinically unresectable disease based on tumor board consensus and review of restaging scans demonstrating locoregional progression or distant metastasis, surgically unresectable disease based on surgical exploration, or suboptimal resection disease still requiring pneumonectomy and still having R1 resection.
Time frame: 6 weeks after completion of chemoradiation therapy (CRT)
Early positron emission tomography (PET) response of group A
Measured by the change in Standard Uptake Value (SUV)max from baseline at the research PET scan in 1 of 3 scheduled time point.
Time frame: Baseline and between standard radiotherapy (RT) fractions 5-6
Early positron emission tomography (PET) response of group B
Measured by the change in Standard Uptake Value (SUV)max from baseline at the research PET scan in 1 of 3 scheduled time point.
Time frame: Baseline and between standard radiotherapy (RT) fractions 10-11
Early positron emission tomography (PET) response of group C
Measured by the change in Standard Uptake Value (SUV)max from baseline at the research PET scan in 1 of 3 scheduled time point.
Time frame: Baseline and between standard radiotherapy (RT) fractions 15-16
Pathologic response
Time frame: 6 weeks after completion of chemoradiation therapy (CRT)
Progression-free survival
Time frame: Every 3 months for 2 years and every 6 months thereafter
Overall survival
Time frame: Every 3 months for 2 years and every 6 months thereafter
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