A trial looking at radiotherapy in small cell lung cancer (REST)

This trial is looking at radiotherapy after chemotherapy for people who have small cell lung cancer (SCLC) that has spread beyond the lungs (extensive disease).

Doctors usually treat extensive disease small cell lung cancer (SCLC) with chemotherapy. They most often use a platinum chemotherapy drug and another chemotherapy drug called etoposide.

This treatment may work quite well at first, causing the cancer to shrink, or even disappear in some people. But sadly, the cancer comes back in most people. Doctors hope that giving radiotherapy to the chest will help to delay the cancer coming back.

This trial aims to find out if having radiotherapy to the chest after platinum chemotherapy will help to delay the cancer coming back.

Recruitment

Start 18/02/2011

End 01/12/2012

Phase

Phase 3

Who can enter

You can enter this trial if

You had small cell lung cancer that had spread beyond the lungs when you were diagnosed (extensive disease)
Your lung cancer got smaller when you had chemotherapy containing a platinum drug
You had your last chemotherapy between 4 and 6 weeks ago
You are well enough to be up and about for at least half the day (performance status 0, 1 or 2)
You are able to have radiotherapy to the chest
You are at least 18 years old

You cannot enter this trial if you

Have lung cancer that has spread to your brain
Have already had radiotherapy to your brain or chest

Trial design

This is a randomised trial. The people taking part are put into 2 treatment groups by a computer. Neither you nor your doctor will be able to decide which group you are in.
When you have finished your chemotherapy you will be put into either group 1 or 2.

Group 1 will have radiotherapy to the chest. Group 2 will not have radiotherapy and are known as the control group.

If you are in group 1, you will have radiotherapy to your chest every day for 2 weeks. You do not need to stay in hospital but will have to come in every day for treatment.

Please note that everyone in this trial (groups 1 and 2) will have radiotherapy to the brain. This is called prophylactic radiotherapy. It is standard treatment for small cell lung cancer and aims to prevent the cancer spreading to the brain.

Hospital visits

You will see the doctors and have some tests before you start treatment. The tests include

Chest X-ray
Physical examination
CT scan

After joining the trial, everyone will see the doctor at 6 weeks, 3 months, 6 months, 9 months and a year. At these appointments, you will have a physical examination and a chest X-ray.

The doctors will then see you every 6 months and you will have a chest X-ray at each visit.

Side effects

You may have side effects from radiotherapy to the chest. The most common are

Chest pain during the first 24 hours which will go away
Cough
Tiredness
Pain on swallowing
Shortness of breath, this can start towards the end of your radiotherapy and even when the radiotherapy has finished and may last for up to 6 weeks
Skin reaction like sun burn

There is more information about radiotherapy side effects on CancerHelp UK.