Markerless Image Guidance Using Intrafraction Kolovoltage X-ray Imaging for Lung Cancer Radiotherapy

NCT ID: NCT04310891

Last Updated: 2023-11-18

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

RECRUITING

Total Enrollment

10 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-12-04

Study Completion Date

2025-12-31

Brief Summary

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In radiotherapy, tumour tracking allows us to ensure the radiation beam is accurately targeting the tumour while it moves in a complex and unpredictable way. Most tumour tracking techniques require the implantation of fiducial markers around the tumour. Markerless Tumour Tracking negates the need for implanted markers, enabling accurate and optimal cancer radiotherapy in a non-invasive way.

Detailed Description

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We will perform a phase I observational trial investigating the feasibility of the Markerless Tumour Tracking technology. Markerless Tumour Tracking will be integrated with existing treatment machines to provide real-time monitoring of tumour motion during treatment delivery. Eligible patients are implanted with fiducial markers, which act as the ground truth for evaluating the accuracy of Markerless Tumour Tracking. The patients will undergo the current standard of care radiotherapy, with the exception that kilovoltage x-ray images will be acquired continuously during treatment delivery and used to calculate online Markerless Tumour Tracking. Markerless Tumour Tracking determines the mean tumour position calculated over the most recent 15 seconds and displays shifts exceeding 3 mm.

The trial will be a single-institution study recruiting only at RNSH Radiation Oncology Department.

As this trial investigates feasibility, our focus will be on estimating the proportion of treatment time in which the Markerless Tumour Tracking is within acceptable limits.

Conditions

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Lung Cancer Markerless Image Guidance Intrafraction Kolovoltage X-ray Imaging

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Markerless

Markerless Tumour Tracking will be used to observe the radiation beam is accurately targeting the tumour.

Markerless Tumour Tracking

Intervention Type RADIATION

Intrafraction Kolovoltage X-ray Imaging using Fiducials

Interventions

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Markerless Tumour Tracking

Intrafraction Kolovoltage X-ray Imaging using Fiducials

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

1. Aged 18 or older.
2. Has provided written Informed Consent for participation in this trial and is willing to comply with the study.
3. Patients undergoing external beam radiotherapy.
4. Histologically proven Stage I NSCLC or oligometastatic lung metastases (3 or less).
5. Diagnostic CT prior to insertion of fiducial markers.
6. Patient must be able to have fiducial markers placed in the lung (if on anticoagulants, must be cleared by LMO or cardiologist).
7. ECOG performance status 0-2.
8. A maximum of three metastases to the lung from any non-haematological malignancy. Multiple metastases will be treated separately.
9. 1 cm ≤ Tumour diameter in any dimension ≤ = 5 cm.
10. The distance between the tumour centroid and the top end of the diaphragm is \<=8 cm.

Exclusion Criteria

1. Patient has low respiratory performance as evaluated by the physicians.
2. Previous high-dose thoracic radiotherapy.
3. Less than one fiducial marker implanted in the lung.
4. Fiducial markers are too far from the tumour centroid (\>9 cm).
5. Cytotoxic chemotherapy within 3 weeks of commencement of treatment, or concurrently with treatment. Hormonal manipulation agents are allowable (e.g. aromatase inhibitors, selective oestrogen receptor modulators, and gonadotropin releasing hormone receptor modulators).
6. Targeted agents (such as sunitinib, bevacizumab and tarceva) within 7 days of commencement of treatment, concurrently with treatment or 7 days after radiotherapy.
7. Women who are pregnant or lactating.
8. Unwilling or unable to give informed consent.
9. Unwilling or unable to complete quality of life questionnaires.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Sydney

OTHER

Sponsor Role collaborator

Royal North Shore Hospital

OTHER

Sponsor Role lead

Responsible Party

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Dasantha Jayamanne

Radiation Oncologist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Dasantha Jayamanne, MD

Role: PRINCIPAL_INVESTIGATOR

Royal North Shore Hospital

Locations

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Royal North Shore Hospital

Saint Leonards, New South Wales, Australia

Site Status RECRUITING

Countries

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Australia

Central Contacts

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Carol Kwong, RN

Role: CONTACT

+61294631339 ext. 31339

Heidi Tsang, RN

Role: CONTACT

+61294631340 ext. 31340

Facility Contacts

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Carol Kwong, RN

Role: primary

+61 29463 1339 ext. 31339

Heidi Tsang, RN

Role: backup

+61294631340 ext. 31340

Other Identifiers

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VALKIM

Identifier Type: -

Identifier Source: org_study_id

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