Daily Adaptive Radiation Therapy: An Individualized Approach for Stage III Lung Cancer

Inclusion Criteria

• •1. Provision of signed and dated informed consent form.
• •2. Histologically confirmed NSCLC
• •3. Clinical stage IIIA-IIIB (AJCC v8) disease who are either:
• •1. Patients classified as non-operable by the treatment team
• •2. Patients who refuse surgery
• •4. Clinical stage IIIC due to contralateral mediastinal lymph node involvement only (e.g., no contralateral hilar or any supraclavicular/cervical lymph node metastases). Mediastinal stations 2R and 4R are considered contralateral for patients whose primary tumor is within the left lung. Mediastinal stations 2L, 4L, 5, and 6 are considered contralateral for patients whose primary tumor is in the right lung.
• •5. Completed evaluation for metastatic disease with no distant metastases identified. Evaluation must include the following:
• •1. History and physical examination within 30 days prior to enrollment.
• •2. Whole body FDG PET-CT for staging within 60 days prior to enrollment
• •3. Brain MRI or contrast enhanced CT within 60 days prior to enrollment.
• •6. ECOG performance status 0-2 and deemed clinically fit for chemoradiotherapy.
• •7. Age ≥18 years (or at least the local age of consent)
• •8. Patients must have normal organ and marrow function.
• •9. Serum creatinine ≤1.5 mg/dL within 60 days prior to enrollment.
• •10. Measurable disease must be present.
• •11. Negative urine or serum pregnancy test within 14 days prior to enrollment for women of childbearing potential.