Pelvic Cancer Registry for Online Adapted Radiotherapy

Last updated: February 6, 2024
Sponsor: University Medical Center Goettingen
Overall Status: Active - Recruiting

Phase

N/A

Condition

Pelvic Cancer

Treatment

N/A

Clinical Study ID

NCT06185062
2023-02727
  • Ages > 18
  • All Genders

Study Summary

This prospective registry-based trial will include patients with pelvic or thoracic tumors with an indication for radiotherapy treated with oART or IGRT. For the primary endpoint and the secondary clinical endpoints, the trial will compare oART versus IGRT, for technical endpoints the trial will compare the real oART scenario with two virtual (hypothetical) control scenarios.

Primary endpoint:

  • 10% reduction in the rate of acute radiotherapy related toxicity (≥ CTCAE II°, v5.0) using oART

Secondary endpoints:

  • Clinical endpoints: Tumor control, late toxicities compared to conventional irradiated patients, quality of life and patient-reported outcomes

  • Technical endpoints: Target volume, target coverage, dose to organs at risk, anatomical variability score

Eligibility Criteria

Inclusion

INCLUSION CRITERIA

  • Patients with pelvic or thoracic tumors with an indication for radiotherapy

  • Patient information and declaration of consent

  • Patients age ≥ 18 years

EXCLUSION CRITERIA

  • Prior radiotherapy in affected site

Study Design

Total Participants: 846
Study Start date:
January 01, 2024
Estimated Completion Date:
April 30, 2030

Study Description

Background: Conventional Radiotherapy (Image Guided Radiotherapy, IGRT) requires a CT-based treatment planning process a priori. During this process, a treatment plan is calculated, which then is applied to the patient with a linear accelerator on a daily basis, possibly using image guidance to account for variability in patient position. However, daily changes of the anatomy of targets and organs at risk (OARs) can only be addressed by applying additional safety margins, resulting in larger irradiated volumes and possibly higher toxicity.

A promising and innovative technique for margin and in consequence toxicity reduction is online Adaptive Radiotherapy (oART) using daily imaging to create a "plan of the day" aligned to the actual anatomy by means of artificial intelligence (AI) and with the patient on the treatment couch. This approach is especially promising in the pelvic region due to the high anatomic variability, e.g. caused by peristalsis or volume changes of bladder and rectum. Furthermore, the application of oART in the field of thoracic tumors is being evaluated. oART is an already established form of treatment which is used regulary everyday in clinical practice and is not a study-related intervention. A direct comparison of both techniques IGRT vs. oART is missing.

Methods: This prospective and retrospective registry-based trial will include patients with pelvic or thoracic tumors with an indication for radiotherapy treated with oART or IGRT. For the primary endpoint and the secondary clinical endpoints, the trial will compare oART versus IGRT, for technical endpoints the trial will compare the real oART scenario with two virtual (hypothetical) control scenarios as follows:

  • oART - Applied treatment: AI-based daily treatment plan creation, adapted to daily anatomy

  • Virt 1 - Hypothetical dose distribution of initial treatment plan, based on the initial planning CT

  • Virt 2 - Hypothetical dose distribution of initial treatment plan, applied to the anatomy of the day as depicted by cone-beam CT at the treatment machine

Connect with a study center

  • University Medical Center, Departement of Radiation Oncology

    Göttingen,
    Germany

    Active - Recruiting

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