Type of publication:
Conference abstract
Author(s):
Raj S.; Ellanna G.; Vicky S.; Jo H.; Matthew J.; Louise H.; Manreet T.; Apurna J.; Qamar G.; *Anirban C.; Charles P.; Jane R.; Bleddyn J.; Janet D.
Citation:
Lung Cancer. Conference: 23rd Annual British Thoracic Oncology Group Conference 2025. Belfast Ireland. 200(Supplement 1) (no pagination), 2025. Article Number: 108368. Date of Publication: 01 Feb 2025.
Abstract:
Introduction Significant advances in systemic therapy have improved survival for patients with advanced-stage non-small cell lung cancer (NSCLC). However, current treatment strategies and dose-fractionation for high-dose palliative radiotherapy (RT) are based on trials from the 1990s, when RT planning was simple, typically parallel-pair or 3-dimensional conformal, with less precise delivery. Contemporary lung RT uses 4D-CT, volumetric modulated arc radiotherapy (VMAT), aided by online cone beam CT verification, which enable greater accuracy, better target volume coverage, whilst reducing doses to normal organs at risk. Methods and Results: The SHiP-Rt study aims to evaluate the safety and efficacy of reducing the number of RT fractions and RT duration, using contemporary planning, verification, and delivery techniques. This single-arm, multi-centre, phase-II study will evaluate the shortened hypofractionated accelerated palliative RT regimen of 30 Gy in 6 alternate-day fractions, with strict normal tissue dose constraints. We aim to recruit 37 patients, across 4 sites within the West Midlands. The RTTQA will support quality assurance for the RT. Patients with locally-advanced or metastatic NSCLC, who are candidates for high-dose palliative RT, before or after first-line systemic therapy are eligible for recruitment. The primary objective of this study is to assess the safety of the proposed dose-fractionation. Secondary objectives include evaluating toxicity profiles, patient-reported outcome measures (PROMS), Time to Progression (TTP), feasibility and the NHS cost-saving. Developed in collaboration with the Warwick CTU, this study was favourably reviewed by NCRI CTRad, NCRI lung CSG, and the RTTQA. Funding was awarded by the UHCW Charity and Coventry Hospitals Charity. Conclusion This study is open to recruitment. The potential advantages from this regimen include RT given in fewer fractions and hospital visits, resulting in cost-savings for the NHS and opportunity benefits for other patients. If successful, this study will support a phase-III randomised controlled trial to assess efficacy.
