Image-Guided Gynecologic Brachytherapy

NCT ID: NCT02993900

Last Updated: 2025-12-18

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 54 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2016-12-15
• Study Completion Date: 2028-12-31

Brief Summary

This research is being done to evaluate multimodality imaging, including magnetic resonance imaging-guided therapy (MRT), as a possible treatment for gynecologic cancers. The therapy takes place in the Department of Radiation Oncology at the Johns Hopkins SKCCC. The purpose of this study is to investigate the ability of MRI to successfully guide the placement of the brachytherapy applicator necessary to treat participants' gynecologic cancer. The Investigators want to see if the use of MRI will do a better job of assessing the tumor at the time of brachytherapy than the routinely used CT scan. The Investigators also want to determine if the use of MRI will enable doctors to reduce the radiation dose received by the body during the process of treating the tumor.

Detailed Description

The goal of this trial is to assess how magnetic resonance imaging (MRI) may be used to improve tumor and normal tissue volume delineation, reducing toxicity and recurrence in gynecologic brachytherapy. The Investigators will compare dosimetric values to the organs at risk (OAR) with CT versus MRI planning. The Investigators anticipate that MR-planned cases will have lower OAR doses than standard CT-based cases due to more conformal planning. The Investigators will determine dose thresholds for radiation-related toxicity after treatment. The Investigators will compare toxicity rates at 6 months, 1 and 2 years after treatment, thereby enabling improved recommendations on dose limits to the OAR.

Conditions

Cervical Cancer; Uterine Cancer; Vaginal Cancer; Vulvar Cancer; Bladder Cancer

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Image-Guided Brachytherapy

Magnetic Resonance Imaging (MRI) guided brachytherapy Procedure: Image-Guided Brachytherapy

Group Type: EXPERIMENTAL

Image-Guided Brachytherapy

Intervention Type: DEVICE

Brachytherapy will be precisely inserted with the assistance of magnetic resonance (MRI) scans

Interventions

Image-Guided Brachytherapy

Brachytherapy will be precisely inserted with the assistance of magnetic resonance (MRI) scans

Intervention Type: DEVICE

Eligibility Criteria

Inclusion Criteria

• Participants must have histologically or cytologically confirmed carcinoma. Central pathology review is not required; however, pathology will be reviewed at the SKCCC at Johns Hopkins.
• Site/Stage
• Any patient eligible for internal implantation without MR guidance will be considered eligible for this protocol. Standard criteria for internal implantation include:
• Carcinoma of the cervix: Stage I-IVA or vaginal recurrence
• Carcinoma of the uterus: Stage IIIB (vaginal involvement), inoperable, or vaginal recurrence
• Carcinoma of the vagina: Stage I-IVA or vaginal recurrence
• Carcinoma of the vulva: Stage I-IVA or recurrence
• Carcinoma of the urethra based on treating physician's discretion
• Patients who have received prior radiation or chemotherapy may be enrolled on this study.
• Age > 18 years. Children do not develop these malignancies and therefore are not considered candidates for this trial.
• Life expectancy of greater than 6 months.
• ECOG performance status of <2 or greater, based on treating physician's discretion
• MRI of the pelvis or PET-CT within 4 months before registration
• Ability to understand and the willingness to sign a written informed consent document.

Exclusion Criteria

• Uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
• Absolute neutrophil count < 500 at the time of enrollment
• A history of metal in the head or eyes

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 100 Years
• Eligible Sex: FEMALE
• Accepts Healthy Volunteers: No

Sponsors

National Cancer Institute (NCI)

NIH

Sponsor Role: collaborator

Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Akila Viswanathan, M.D.

Role: PRINCIPAL_INVESTIGATOR

Johns Hopkins Department of Radiation Oncology

Locations

The SKCCC at Johns Hopkins

Baltimore, Maryland, United States

Site Status: RECRUITING

Countries

United States

Central Contacts

Shirley DiPasquale, R.N.

Role: CONTACT

Phone: 410-614-1598

Email: sdipasq1@jhmi.edu

Facility Contacts

Shirl DiPasquale, R.N.

Role: primary

Other Identifiers

IRB00098525

Identifier Type: OTHER

Identifier Source: secondary_id

R21CA167800

Identifier Type: NIH

Identifier Source: secondary_id

View Link

J1660

Identifier Type: -

Identifier Source: org_study_id