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OBJECTIVES

Primary Objective

Compare overall survival (

OS

).The rationale in this trial is to determine if proton therapy can

improve overall survival by reducing the risk of severe toxicity to organs at risk compared to

photon-based IMRT.

Secondary Objectives

To compare 2-year progression-free survival (

PFS)

To compare the development of grade 3 or higher adverse events

To compare differences between the two arms in

QOL

based primarily on the development

of shortness of breath at 6 months, the development of sore throat at the end of

chemoRTas, and breathing related functioning impairments (Shortness ofBreath

Questionnaire [SOBQ])

To compare

cost-effectiveness

outcomes between the 2 arms;

1)

initial therapy costs;

2)

costs of managing side effects as determined by this study

3)

costs of managing recurrence.

To compare pulmonary function changes by treatment arms and response;

To explore the most appropriate and clinically relevant

technological parameters

to

ensure quality and effectiveness throughout radiation therapy processes, including imaging,

simulation, patient immobilization, target and critical structure definition, treatment planning,

image guidance and delivery.

RTOG- 1308 cont..