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Radiation Therapy Planning of Non-Small Cell Lung Cancer based on PET/CT (Radiation Oncology component)
Closed for proposals
Project Type
Project Code
E33038CRP
2001Approved Date
Status
Start Date
Expected End Date
Completed Date
16 June 2023Participating Countries
Description
Non-small cell lung cancer (NSCLC) is considered in many countries as a leading cause of cancer related morbidity and mortality. While curative radiation therapy can be performed on patients who are surgically inoperable, local control and overall survival rates have historically been low, possibly due to inappropriate selection of patients and uncertainties in target definition.
Objectives
Determine the impact of PET/CT in RTP on 2-year overall survival rates for patients with stage III NSCLC receiving chemo-radiotherapy with curative intent.
Specific objectives
To improve the quality and reproducibility of PET/CT-based radiation therapy target volume definition in patients with NSCLC by means of a training intervention
Impact
This has been a high impact and very important CRP. It has demonstrated that multiple training interventions significantly improves PET/CT based lung cancer radiotherapy target volume delineation following an IAEA based delineation protocol. In addition it has developed and published an original delineation guideline for radiotherapy for non-small cell lung cancer.
During the CRP is was possible to achieve the expected results and prove the primary and secondary objectives.
In addition, some important milestones were achieved.
Milestones achieved:
a) EARL accreditation standardized PET/CT protocols and image quality of PET scans across all centres;
b) Accessibility to NEMA phantoms for PET/CT QA;
c) Change in clinical practice;
d) Adoption of new protocol;
e) Collaboration improved between RT and NM;
f) PET/CT became an important upfront technology, all stage III patients get PET/CT;
g) PET/CT in treatment position for all lung cancer patients;
h) More confidence is observed in treating patients more radically with CCRT, but also in target volume delineation;
i) Participating in PERTAIN opened eyes for more research;
j) Increased the awareness of other centres on FDG PET/CT applications;
k) Centres disseminate expertise learned from CRP training interventions through seminars and conferences;
l) Better patient selection for CCRT is achieved.
Relevance
Very relevant.
Non-small cell lung cancer (NSCLC) is considered in many countries as a leading cause of cancer related morbidity and mortality. While curative radiation therapy can be performed on patients who are surgically inoperable, local control and overall survival rates have historically been low, possibly due to inappropriate selection of patients and uncertainties in target definition.
Non-small cell lung cancer continues to be the most frequent form of lung cancer as a result of cigarette smoking in most cases. Adding to this risk factor the breathing of polluted air in many highly populated cities as well as radon gas exposure increase the risk. This CRP showed that multiple training events and an PET-CT imaging-based delineation protocol can strongly improve the skill of radiation oncologists at the time of planning radiation therapy. In addition, it has strengthened the ties of collaboration between radiation oncologists and medical imaging specialists, which is a condition in this type of multidisciplinary approach.
This CRP that included 9 research centres in 7 countries contributes to achieve the SDG goal 3.4, by 2013 reduce by 30% the premature mortality due to NCDs. Which is in line with the objective of programme 2.2. of Supporting MS to address their health needs related to the prevention, diagnosis and treatment using radiation medicine. In the case of the CRP E13042 (nuclear medicine component) that was
conducted in parallel with the CRP E33038 (radiation oncology component) aimed at supporting the management of patients with NSCLC which is a highly prevalent cancer and to Improvement patient outcomes