Adaptive Radiotherapy Using Plan Selection for Bladder Cancer

NCT ID: NCT01762527

Last Updated: 2021-05-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

65 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-10-31

Study Completion Date

2016-10-30

Brief Summary

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This protocol describes a Phase 2 clinical trial of online adaptive Radiotherapy, using a library of 3 dose plans corresponding to Small, Medium and Large size bladder. The procedure includes 'Common Toxicity Criteria for Adverse Effects'(CTCAE) for registration of adverse effects (baseline, every 2'nd week during RT, 2 weeks, 3, 6, 12 and 24 month after RT) as well as cineMR for intra-fractional motion (baseline and every week during RT). Patients receive standard non-adaptive RT in the first week. Delineations of the bladder on the Cone-Beam scans (CBCT) from first week of treatment are used for planning the Small and Medium size bladder plans. Large size plan are the standard non-adaptive treatment plan used for the first week of treatment. A margin of 5 mm for intra fractional movement is used.

Detailed Description

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After inclusion patients are asked about their adverse effects by an oncologist using CTCAE (version 4.0) questionnaire. A planning CT-scan is acquired and for the first 10 patients also a MR-scan for intra fractional motion is acquired. The MR sequence is repeated every week during radiotherapy. The first week of treatment a standard non-adaptive IMRT-plan is used and CBCT-scans are acquired before and after treatment. The CBCT-scans are used for delineation of the bladder on the CBCT-scans from the first 4 fractions. The adaptive plans are generated from the union of the first 4 CBCT-bladders and the planning CT bladder (medium size) and the volume contained in at least 2 out of the 5 bladder volumes (small size). Details can be found in the reference list. From the 6'Th fraction the treatment is performed using the most appropriate size of treatment plan. CTCAE is repeated every other week during radiotherapy and 2 weeks, 3, 6, 12 and 24 month after radiotherapy.

Conditions

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Adverse Effects for Adaptive RT of Bladder Cancer

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Daily adaptation of radiotherapy
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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ART

Online adaptive radiotherapy

Group Type EXPERIMENTAL

Adaptive Radiotherapy

Intervention Type RADIATION

CTCAE scoring baseline, every 2'nd week during RT, 2 weeks, 3, 12 and 24 month after RT cineMR (time resolved MR) baseline and weekly during RT for intra fractional motion

Interventions

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Adaptive Radiotherapy

CTCAE scoring baseline, every 2'nd week during RT, 2 weeks, 3, 12 and 24 month after RT cineMR (time resolved MR) baseline and weekly during RT for intra fractional motion

Intervention Type RADIATION

Other Intervention Names

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Online Adaptive RT using plan selection

Eligibility Criteria

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Inclusion Criteria

* Histologically proven bladder cancer
* Age over 18 years
* Urothelial or planocellular carcinoma
* Stage T2 T4A
* Stage N0M0
* Suitable for radiotherapy
* ECOG/WHO performance status 0-2

Exclusion Criteria

* Suspected or confirmed distant metastases
* Previous surgery in the small pelvis
* Inflammatory bowel disease
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Copenhagen University Hospital at Herlev

OTHER

Sponsor Role collaborator

Odense University Hospital

OTHER

Sponsor Role collaborator

University of Aarhus

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Morten Høyer, MD, Professor

Role: PRINCIPAL_INVESTIGATOR

Aarhus University Hospital

Locations

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Department of Oncology, Aarhus University Hospital

Aarhus, , Denmark

Site Status

Herlev Hospital

Herlev, , Denmark

Site Status

Odense University Hospital

Odense, , Denmark

Site Status

Countries

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Denmark

References

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Vestergaard A, Sondergaard J, Petersen JB, Hoyer M, Muren LP. A comparison of three different adaptive strategies in image-guided radiotherapy of bladder cancer. Acta Oncol. 2010 Oct;49(7):1069-76. doi: 10.3109/0284186X.2010.501813.

Reference Type BACKGROUND
PMID: 20831498 (View on PubMed)

Vestergaard A, Hafeez S, Muren LP, Nill S, Hoyer M, Hansen VN, Gronborg C, Pedersen EM, Petersen JB, Huddart R, Oelfke U. The potential of MRI-guided online adaptive re-optimisation in radiotherapy of urinary bladder cancer. Radiother Oncol. 2016 Jan;118(1):154-9. doi: 10.1016/j.radonc.2015.11.003. Epub 2015 Nov 26.

Reference Type BACKGROUND
PMID: 26631646 (View on PubMed)

Vestergaard A, Muren LP, Lindberg H, Jakobsen KL, Petersen JB, Elstrom UV, Agerbaek M, Hoyer M. Normal tissue sparing in a phase II trial on daily adaptive plan selection in radiotherapy for urinary bladder cancer. Acta Oncol. 2014 Aug;53(8):997-1004. doi: 10.3109/0284186X.2014.928419. Epub 2014 Jun 24.

Reference Type RESULT
PMID: 24957559 (View on PubMed)

Gronborg C, Vestergaard A, Hoyer M, Sohn M, Pedersen EM, Petersen JB, Agerbaek M, Muren LP. Intra-fractional bladder motion and margins in adaptive radiotherapy for urinary bladder cancer. Acta Oncol. 2015;54(9):1461-6. doi: 10.3109/0284186X.2015.1062138. Epub 2015 Aug 27.

Reference Type RESULT
PMID: 26313410 (View on PubMed)

Other Identifiers

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jr.nr. 1-16-02-283-12

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

AUH-KFE-1217

Identifier Type: -

Identifier Source: org_study_id

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