Trial Summary
What is the purpose of this trial?This trial uses a needle guided by ultrasound to sample lymph nodes and precise high-dose radiation to treat patients with advanced lung cancer. It aims to see if sampling lymph nodes gives better information about cancer spread compared to imaging tests alone.
What data supports the idea that Lymph Node Sampling for Lung Cancer is an effective treatment?The available research shows that Lymph Node Sampling for Lung Cancer, specifically using techniques like EBUS-TBNA and EUS-FNA, is effective because it is minimally invasive and helps in diagnosing and staging lung cancer. One study highlights that EBUS-TBNA is well-established for providing important information about lung cancer diagnosis and stage. Another study mentions that these techniques are useful for evaluating mediastinal pathologies, which are related to lung cancer. Overall, these methods are effective because they allow doctors to gather necessary information without needing more invasive procedures.6791112
Do I need to stop my current medications for this trial?The trial protocol does not specify whether you need to stop taking your current medications. Please consult with the trial coordinators or your doctor for guidance.
Is lymph node sampling for lung cancer a promising treatment?Yes, lymph node sampling for lung cancer using endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is promising. It allows doctors to accurately diagnose and stage lung cancer by safely and effectively sampling lymph nodes. This helps in planning the best treatment for patients.123513
What safety data is available for lymph node sampling in lung cancer using EBUS-TBNA and EUS-FNA?EBUS-TBNA and EUS-FNA are generally considered safe and minimally invasive procedures for diagnosing and staging lung cancer. Studies indicate low complication rates, though rare cases of severe complications like mediastinitis and pericarditis have been reported. The procedures are effective in both general and elderly populations, with initial experiences in Brazil confirming their safety and accuracy.4681014
Eligibility Criteria
This trial is for adults over 18 with Non-Small Cell Lung Cancer (NSCLC) who have undergone recent staging investigations. It's aimed at those with a good performance status, up to 5 metastases, and plans for radical treatment of all cancer sites. Pregnant women, individuals unable to consent, or those with contraindications to EBUS/EUS or chest radiotherapy cannot participate.Treatment Details
The study tests if sampling lymph nodes using EBUS-TFNA or EUS-FNA can better determine the extent of nodal disease in NSCLC compared to imaging alone. Participants will also receive Stereotactic Ablative Radiotherapy (SABR), a precise high-dose radiation therapy.
1Treatment groups
Experimental Treatment
Group I: Treatment ArmExperimental Treatment2 Interventions
Small pieces of suspicious chest lymph nodes will be removed with a procedure called endobronchial ultrasound-guided transbronchial fine needle aspiration (EBUS-TFNA) or transesophageal ultrasound-guided fine needle aspiration (EUS-FNA).
Find a clinic near you
Research locations nearbySelect from list below to view details:
London Health Sciences Centre - London Regional Cancer ProgramLondon, Canada
Sunnybrook Health Sciences CentreToronto, Canada
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Who is running the clinical trial?
London Health Sciences Centre Research Institute and Lawson Research Institute of St. Joseph'sLead Sponsor
Lawson Health Research InstituteLead Sponsor
Academic Medical Organization of Southwestern OntarioCollaborator
References
Efficacy of endobronchial ultrasound-guided transbronchial needle aspiration of hilar lymph nodes for diagnosing and staging cancer. [2016]Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is used mostly in patients with non-small cell lung cancer (NSCLC) to sample mediastinal lymph nodes that are visible on computed tomography (CT). We sought to determine the efficacy of EBUS-TBNA in sampling enlarged hilar lymph nodes in this patient population.
Combined endoscopic-endobronchial ultrasound-guided fine-needle aspiration of mediastinal lymph nodes through a single bronchoscope in 150 patients with suspected lung cancer. [2022]For mediastinal lymph nodes, biopsies must often be performed to accurately stage lung cancer. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) allows real-time guidance in sampling paratracheal, subcarinal, and hilar lymph nodes, and endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) can sample mediastinal lymph nodes located adjacent to the esophagus. Nodes can be sampled and staged more completely by combining these procedures, but to date use of two different endoscopes has been required. We examined whether both procedures could be performed with a single endobronchial ultrasound bronchoscope.
Efficacy of convex probe endobronchial ultrasound (CP-EBUS) assisted transbronchial needle aspiration for mediastinal staging in non-small cell lung cancer cases with mediastinal lymphadenopathy. [2019]Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a sampling method for the patients with non-small cell lung cancer (NSCLC) that have enlarged mediastinal lymph nodes that are detected with computed tomography (CT). We aimed to investigate the value of EBUS-TBNA in sampling enlarged mediastinal lymph nodes in the patient with NSCLC.
[A case of acute mediastinitis after endobronchial needle aspiration]. [2013]Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has become widespread, but reports of complications are rare.
Modified technique for obtaining mediastinal samples with endobronchial ultrasound-guided transbronchial needle aspiration: results from a prospective observational study. [2016]Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a widely-accepted method for obtaining both benign and malignant mediastinal lymph node samples. We present the results obtained with a modification that simplifies sampling, known as fine-needle capillary sampling or EBUS-FNC.
Transbronchial vs transesophageal needle aspiration using an ultrasound bronchoscope for the diagnosis of mediastinal lesions: a randomized study. [2017]The purpose of this study was to compare the tolerance, efficacy, and safety of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) with transesophageal endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) with an endobronchial ultrasound scope for the first pathologic diagnosis of lesions accessible by both procedures.
Utility of endoscopic ultrasound-guided transbronchial fine-needle cytology in the diagnosis of sarcoidosis: A Saudi experience. [2020]Endoscopic ultrasound-guided transbronchial fine-needle aspiration (EBUS-TFNA) is a minimally invasive technique for diagnosis of mediastinal masses/lesions. Although most studies have reported the utility of EBUS-TFNA in malignancy, its use has been extended to the benign conditions as well.
Endobronchial ultrasound-guided transbronchial needle aspiration for lung cancer staging: early experience in Brazil. [2018]Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive, safe and accurate method for collecting samples from mediastinal and hilar lymph nodes. This study focused on the initial results obtained with EBUS-TBNA for lung cancer and lymph node staging at three teaching hospitals in Brazil.
Establishment of an endobronchial ultrasound-guided transbronchial fine needle aspiration service with rapid on-site evaluation: 2 years experience of a single UK centre. [2017]Endobronchial ultrasound (EBUS)-guided transbronchial fine needle aspiration (TBFNA) is now well established as a minimally invasive, effective investigation which can provide information on both diagnosis and stage of lung cancer and is also useful in the investigation of mediastinal lymphadenopathy of uncertain aetiology. The service can be provided with or without rapid on-site evaluation (ROSE) for specimen triage and provisional diagnosis. We outline our experience from the first 2 years of providing an EBUS service with ROSE, highlighting the practicalities of service provision, pitfalls encountered and lessons learned.
Endobronchial ultrasound transbronchial needle aspiration in elderly patients: safety and performance outcomes EBUS-TBNA in elderly. [2022]Complication rates are low and endobronchial ultrasound guided needle aspiration (EBUS-TBNA) is generally regarded as a safe procedure, but there is a very limited number of studies evaluating the efficacy and safety of the procedure in advanced ages. The aim of this study is to assess the safety and performance outcomes of EBUS-TBNA in elderly.
Utility and safety of endobronchial ultrasound-guided transbronchial needle aspiration and endoscopic ultrasound with an echobronchoscope-guided fine needle aspiration in children with mediastinal pathology. [2020]Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and endoscopic ultrasound with an echobronchoscope-guided fine needle aspiration (EUS-B-FNA) are useful modalities in the evaluation of mediastinal pathologies in adults. However, sparse data are available in children.
Evaluation and Comparison of Performance Parameters and Impact of Telepathology and Operator Experience on Endobronchial and Endoscopic Ultrasound-Guided Fine-Needle Aspiration. [2021]Endobronchial ultrasound- and endoscopic ultrasound-guided fine-needle aspiration (EBUS-/EUS-FNA) are minimally invasive techniques of diagnosing and staging malignancies. The procedures are difficult to master, requiring specific feedback for optimizing yield.
Prospective randomized trial to compare the safety, diagnostic yield and utility of 22-gauge and 19-gauge endobronchial ultrasound transbronchial needle aspirates and processing technique by cytology and histopathology. [2022]Endobronchial ultrasound (EBUS)-guided transbronchial needle aspirate (TBNA) is a widely used method of minimally invasive lymph node sampling. The benefit of processing samples by cytologic methods versus "core biopsy" is unclear. It is unknown if safety or diagnostic yield varies by needle gauge.
Severe mediastinitis and pericarditis after endobronchial ultrasound-guided transbronchial needle aspiration: A case report. [2022]Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a safe and minimally invasive diagnostic tool for mediastinal and hilum evaluation. However, infectious complications may occur after EBUS-TBNA. Among these, mediastinitis and pericarditis are rare.