Abstract

Introduction
Current palliative thoracic radiotherapy practice is still based on dose fractionations studied in the 1990s. The symptomatic benefits demonstrated in those trials are widely assumed to be transferable to late-stage Non-Small Cell Lung Cancer (NSCLC) patients with poor performance status who are considered unfit for systemic treatment. When considered how palliative care has evolved over the past three decades, the benefits of this practice must be re-assessed in the current setting.

Aims
QUARTZ LUNG is a candidate-specific trial within the TOURIST platform evaluating the role of low-dose, palliative thoracic radiotherapy as a single-modality treatment for stage IIIB, IIIC, and IV NSCLC patients who have no planned systemic therapy.

Methods
Patients receive their standard of care supportive and palliative care to alleviate symptoms and are randomised (1:1) to the control arm or the addition of low-dose thoracic radiotherapy. The primary objective is to assess clinical effectiveness of the additional radiotherapy on health utility. Secondary objectives are to determine the clinical effectiveness of the additional radiotherapy on overall survival, quality of life, lung cancer symptoms, and toxicity. Economic evaluations are to be undertaken, alongside process evaluations via interviews with patients, their primary carers and healthcare professionals. Trial Update We currently have 30 sites open across England, Scotland, Wales, and Northern Ireland, with recruitment expected to end in March 2029. 20 patients have been recruited to date. Early recruitment has been challenging; recent changes have been introduced to improve accrual, including extending the inclusion criteria to patients with stage IIIB and IIIC, as well as those who have received prior systemic therapy. We have strong PPI representation, who contribute to trial design and oversight. They also contribute in various ways to raise trial awareness, for example participating in interviews alongside our Chief Investigator
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Disclosure
No significant relationship.