This study is for patients with EFGR gene sensitive mutations diagnosed by pathology or cytology, having a course of chest radiotherapy treatment and molecular Target Therapy for the treatment of stage IV non-small cell lung cancer. Patients with non-small cell lung cancer have a risk of the tumour in the lung recurring or progressing after treatment. In this study, the investigators aim to verify the following hypothesis: * whether in combination with concurrent or concomitant EGFR-TKI regimen chemotherapy, Intensity Modulated Radiation Therapy can reduce the risk of the tumour in the lung recurring or progressing similarily. * Intensity Modulated Radiation Therapy concomitant with EGFR-TKI has a better normal tissue dose/volume tolerance than concurrent regimen. * the survival can be improved by using this new molecular Target-radiotherapy method.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
160
·EGFR-TKI:gefitinib will be administered 250mg/d ivgtt qd; icotinib will be administered 150mg/d ivgtt tid;
High dose group:DTGTV=70Gy; * first course radiotherapy:40Gy/20f/4w(DTPTV:36Gy/20f/4w),2Gy/f/d; * late course radiotherapy:1.5Gy/f、2f/d、interval≥6 hs、DTGTV=30Gy(DTPTV=27Gy)。 Low dose group:DTGTV=50Gy; * first course radiotherapy:32Gy/16f/3w(DTPTV为28.8Gy/16f/3w),2Gy/f/d; * late course radiotherapy:1.5Gy/f、2f/d、interval≥6小时、DTGTV为18Gy(DTPTV为16.2Gy)。
The affiliated hospital of Guizhou medical university
Guiyang, Guizhou, China
Therapeutic efficacy of EGFR-TKI and concurrent/concomitant local RT in NSCLC patients.
Tumor Response will be evaluated using the RECIST system. Modified WHO criteria will be used for measurement of tumors. The irradiated lesion will be excluded from the assessment of response.
Time frame: >4 weeks post treatment
Overall survival (OS)
Overall survival is defined as the time interval from date of diagnosis to date of death from any cause
Time frame: Up to 5 years
Progression-free survival (PFS)
PFS is defined as the duration of time from start of treatment to time of progression or death, whichever occurs first. Progressive disease (PD) = at least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study, appearance of one or more non-target lesion(s) and/or unequivocal progression of existing non-target lesions
Time frame: Up to 5 years
Objective response rate(ORR)
Partial response + complete response per RECIST 1.1 criteria Complete response (CR) = disappearance of all target lesions, non-target lesions, and normalization of tumor marker level Partial response (PR) = at least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline of sum diameters
Time frame: Up to 5 years
Disease control rate (DCR)
Percentage of patients who achieve complete response, partial response, or stable disease per RECIST 1.1 criteria. Complete response (CR) = disappearance of all target lesions, non-target lesions, and normalization of tumor marker level Partial response (PR) = at least a 30% decrease in the sum of the diameters of target lesions, taking as reference the baseline of sum diameters Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum diameters while on study.
Time frame: Up to 5 years
Adverse events (toxicities)
The descriptions and grading scales found in the revised NCI Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 will be utilized for all toxicity reporting.
Time frame: Up to 5 years
Local regional progression-free survival(LRPFS)
LRPFS is defined as the duration of time from start of treatment to time of progression or recurrence, whichever occurs first..The target lesions is only for primary tumor and regional positive lymph nodes. Progressive disease (PD) = at least a 20% increase in the sum of the diameters of target lesions, taking as reference the smallest sum on study, appearance of one or more target lesion(s) and/or unequivocal progression of existing target lesions.
Time frame: Time Frame: Up to 5 years
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.