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ALTG 10/001 PLUNG: Randomised Phase III trial of high dose palliative radiotherapy (HDPRT) vs concurrent chemotherapy and HDPRT (C-HDPRT) in patients with good performance status, locally advanced/small volume metastatic NSCLC not suitable for radical chemo-radiotherapy

A 2013 study by the Norwegian Lung Cancer Study Group showed some benefit of radiation therapy for patients not suitable for more radical treatment (Strom et al. British Journal of Cancer 2013). The PLUNG-GP trial is a randomized Phase III trial comparing high dose palliative radiotherapy (HDPRT) with concurrent chemotherapy + HDPRT (C-HDPRT) in patients with good performance status, locally advanced or small volume metastatic NSCLC who are not suitable for radical chemo-radiotherapy, either due to tumour extent or patient factors. The optimal treatment approach for this group of patients is unknown and clinical practice varies throughout Australia. The PLUNG trial compares a widely employed high dose palliative radiotherapy regime (36Gy/12F) with a concurrent chemotherapy and high dose palliative radiotherapy regime (40Gy/20F + Vinorelbine + Cisplatin) which has been investigated in preceding Phase I and II trials conducted under the auspices of the Trans Tasman Radiation Oncology Group (TROG).

The objectives of the trial are to determine which regime is superior in terms of symptom relief and improvement in quality of life. The study aims to recruit 130 patients and has recently received a three year extension of funding from Cancer Australia. The study is open at PAH, Peter Mac, Townsville, Royal Brisbane, Newcastle, Flinders Medical Centre and the Gold Coast Hospital with recruitment now at 36 patients. For anyone who is interested in this study please contact either Dr Margot Lehman (margot.lehman@health.qld.gov.au) or A/Prof Michael Michael (Michael.michael@petermac.org).