This study will test the safety of Quad Shot radiation therapy using 2 different treatment schedules to find out what effects, if any, this treatment has on people with advanced NSCLC who are receiving systemic therapy for their cancer. The Quad Shot treatment schedule reduces the number of days needed to deliver the radiation treatments, which may be less disruptive to systemic therapy schedules.
Histologically confirmed non-small cell lung cancer with metastatic disease detected on cross-sectional imaging with a plan for one of the following systemic therapies:
Carboplatin/paclitaxel Carboplatin/paclitaxel/pembrolizumab Carboplatin/pemetrexed Carboplatin/pemetrexed/pembrolizumab Pembrolizumab (single agent or in combination with other regimens in this list) Cisplatin/pemetrexed Cisplatin/pemetrexed/pembrolizumab Pemetrexed/pembrolizumab Pemetrexed Nivolumab (single agent or in combination with other regimens in this list) Ipilimumab/nivolumab Carboplatin/etoposide Carboplatin/etoposide/atezolizumab Cisplatin/etoposide Cisplatin/etoposide/atezolizumab Durvalumab (single agent or in combination with other regimens in this list) Atezolizumab (single agent or in combination with other regimens in this list) Patients eligible for the systemic therapy regimens notes Patients with Stage IV NSCLC who have symptomatic (defined by patient-reported cough, dyspnea, or hemoptysis) or near-symptomatic (determined radiographically to be threatening the airway, esophagus or vasculature) centrally located. KPS ≥ 60 Age ≥ 18 years. Able to provide informed consent. Patients at reproductive potential must agree to practice an effective contraceptive method.
Exclusion Criteria:
Previous radiotherapy to the intended treatment site that precludes developing a treatment plan that respects normal tissue tolerances. Serious medical co-morbidities precluding radiotherapy. Pregnant or breast-feeding women.
