Prophylactic Proton Pump Inhibition for Esophageal Protection in Lung Radiation Therapy

Launched by LONDON HEALTH SCIENCES CENTRE RESEARCH INSTITUTE OR LAWSON RESEARCH INSTITUTE OF ST. JOSEPH'S · Jul 20, 2025

Keywords

ClinConnect Summary

This clinical trial is studying whether taking a daily medicine called a proton pump inhibitor (PPI), which reduces stomach acid, can help protect the esophagus (the tube that carries food from the mouth to the stomach) from irritation and damage during radiation treatment for lung cancer. Radiation can sometimes cause esophagitis, which means the esophagus becomes sore or inflamed, making it hard or painful to swallow. The study will compare patients who receive the usual care during radiation to those who also take a PPI daily to see if the medicine helps reduce these side effects.

People who might be eligible for this trial are adults aged 18 or older with a diagnosis of lung cancer, including both non-small cell and small cell types, who are about to receive a certain level of radiation treatment to their chest. Participants need to be well enough to undergo treatment and expect to live at least a few months. They should not have used PPIs recently, have painful swallowing before starting the trial, or have allergies to these medicines. If you join, you will be randomly assigned either to the usual care group or the group that takes the PPI every day during radiation. The study is not yet recruiting, but if you qualify and participate, your care team will closely monitor your symptoms and treatment to see if the PPI helps protect your esophagus during therapy.

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Eligibility criteria

• Inclusion Criteria:
• • Age 18 years or older
• • Willing to provide informed consent
• • Eastern Cooperative Oncology Group (ECOG) performance status 0-3
• • Life expectancy of at least 3 months
• • Primary lung malignancy of any stage (including NSCLC and small cell lung cancer). Histologic/pathologic diagnosis is preferred, but not required.
• • Receiving a prescribed dose of at least 40 Gy in 15 fractions (or equivalent). Eligible fractionations include, but are not limited to, 60 Gy in 30 fractions, 55 Gy in 20 fractions, and 40-45 Gy in 15 fractions.
• • On radiation planning, at least 5 cc of esophagus is receiving at least 95% of prescription dose
• Exclusion Criteria:
• • • Serious medical comorbidities precluding radiotherapy
• • Use of PPI within 3 months prior to enrollment
• • Allergy to PPI
• • Odynophagia (painful swallowing) prior to enrollment
• • Pregnant or lactating women
• • Note: previous radiation to the thorax is allowed, as long as the composite plan of current and prior radiation doses meet standard institutional dose constraints, in the opinion of the treating radiation oncologist.